Duplex Assessment of a Newly Developed Controllable Portal-Systemic Shunt

Author： Griffiths Kaye A. Smith Ross C. Kelly Alison T. Meulman Neil B. Gill Robert W.

Publisher： Society for Vascular Ultrasound

ISSN： 1539-5898

Source： Journal of Vascular Technology, Vol.16, Iss.3, 1992-06, pp. : 81-86

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Abstract

We have used duplex ultrasound, including color-flow imaging, as a noninvasive method to study blood flow in patients fitted with a newly developed controllable portal-systemic shunt. In the first 10 patients a subcutaneous reservoir was used to inflate a silicone rubber balloon surrounding an H-graft shunt. In the subsequent 11 patients, an infusaport connected to the balloon cuff allowed more accurate inflation by injecting measured amounts of sterile water. The balloon cuff alters the diameter of the shunt and permits adjustment of the rate of blood flow through it, depending on the clinical status of the patient. The goal of the operation is to partially decompress the portal vein without causing reverse flow through the liver. This is expected to reduce encephalopathy. Use of the cuff has been climcally significant in three patients with encephalopathy. Duplex ultrasound examinations have permitted the hemodynamic consequences of modifying blood flow through the shunt to be assessed.