Portosystemic shunting by interventional radiology

Successful shunting of blood from the portal to the systemic circulation has been shown to reduce or obliterate esophagogastric varices. In recent years it has become possible to establish such channels by a process called transjugular intrahepatic portosystemic shunting. Under radiological guidance, a catheter is passed into the liver through the jugular vein and advanced until a portal channel is ruptured. A stent is then passed to maintain the permanency of this traumatically established portosystemic shunt. Portal pressures drop from hypertensive to normal levels after establishment of the shunts, varices are reduced in number, and repeat variceal hemorrhages greatly reduced. The procedure appears to be much more effective than sclerotherapy of varices but requires very great technical skill ( Skoens et al. 1995).

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Sleep Apnea

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