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Gradual attenuation of a congenital extrahepatic portosystemic shunt with a self‐retaining polyacrylic acid‐silicone device in 6 dogs
Author(s) -
Wallace Mandy L.,
Ellison Gary W.,
Giglio Robson F.,
Batich Christopher D.,
Berry Clifford R.,
Case J. Brad,
Kim Stanley E.
Publication year - 2018
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/vsu.12797
Subject(s) - medicine , portosystemic shunt , shunt (medical) , occlusion , abdominal ultrasonography , surgery , ultrasonography , portal hypertension , cirrhosis
Objective To determine the ability of a polyacrylic acid‐silicone radiolucent self‐retaining gradual occlusion device (PAS‐OD) to attenuate congenital extrahepatic portosystemic shunts (EHPSS) in dogs. Study design Prospective clinical trial. Animals Six client‐owned dogs with single, congenital EHPSS. Methods Serum bile acids (SBA), abdominal ultrasonography, and computed tomographic angiography (CTA) were performed preoperatively and at 4 and 8 weeks postoperatively. Each dog was treated for EHPSS by placement of a PAS‐OD. Results PAS‐OD were placed without complication an average of 4.3 seconds (range, 3‐7) after isolation of the shunt. Median surgical time was 38.5 minutes (range, 28‐84) including concurrent procedures. All dogs recovered from surgery without complications. SBA were normal in 5 of 6 dogs at 4 and 8 weeks after surgery. The shunt was completely attenuated in 2 of 6 dogs at 4 weeks and in 4 of 6 dogs at 8 weeks, without evidence of acquired shunt formation in any dog. The size and velocity of the portal vasculature were improved in 5 of 6 dogs according to 8‐week postoperative CTA and ultrasonography results, respectively. The remaining dog had a persistently decreased portal vasculature size but a normal velocity according to 8‐week postoperative CTA and ultrasound results, respectively. Conclusion The PAS‐OD led to complete attenuation in 4 of 6 dogs and partial attenuation with mild residual flow of 2 EHPSS over an 8‐week period in dogs. Clinical significance The PAS‐OD is a new option for gradual occlusion of congenital EHPSS over 8 weeks.