PURPOSE: To evaluate the usefulness of a percutaneously placed peritoneovenous shunt (PVS) in patients with refractory ascites. MATERIALS AND METHODS: Under fluoroscopic and ultrasonographic (US) guidance, the authors placed a PVS in 55 patients (39 men and 16 women; mean age, 56 years) with refractory ascites and symptomatic abdominal distention. The cause of ascites was liver cirrhosis (n = 36), carcinomatosis (n = 17), ruptured cysts with polycystic kidney disease (n = 1), and idiopathic refractory ascites (n = 1). The authors retrospectively evaluated technical feasibility, shunt patency, complications, and clinical outcomes of each patient. RESULTS: The technical success rate was 100%, and symptomatic improvement was achieved in all but one patient. Complications occurred in 17 of the 55 patients (31%): five patients had variceal bleeding; three patients had ascites leakage; two patients each had disseminated intravascular coagulopathy, transient abdominal pain, shunt infection, and venous thrombosis; and one patient had pulmonary thromboembolism. Thirty patients (54%) died 2-690 days after the procedure (mean, 117 days), and their lifetime shunt patency was 84%. Eight patients were lost to follow-up. Seventeen patients were alive for 60-1,200 days, and their shunt patency was 71%. There was no significant difference in shunt patency between the two groups with benign and malignant ascites. CONCLUSIONS: The percutaneous placement of a PVS was a technically feasible and effective method for symptomatic relief of refractory ascites.
PURPOSE: To evaluate the usefulness of a percutaneously placed peritoneovenous shunt (PVS) in patients with refractory ascites. MATERIALS AND METHODS: Under fluoroscopic and ultrasonographic (US) guidance, the authors placed a PVS in 55 patients (39 men and 16 women; mean age, 56 years) with refractory ascites and symptomatic abdominal distention. The cause of ascites was liver cirrhosis (n = 36), carcinomatosis (n = 17), ruptured cysts with polycystic kidney disease (n = 1), and idiopathic refractory ascites (n = 1). The authors retrospectively evaluated technical feasibility, shunt patency, complications, and clinical outcomes of each patient. RESULTS: The technical success rate was 100%, and symptomatic improvement was achieved in all but one patient. Complications occurred in 17 of the 55 patients (31%): five patients had variceal bleeding; three patients had ascites leakage; two patients each had disseminated intravascular coagulopathy, transient abdominal pain, shunt infection, and venous thrombosis; and one patient had pulmonary thromboembolism. Thirty patients (54%) died 2-690 days after the procedure (mean, 117 days), and their lifetime shunt patency was 84%. Eight patients were lost to follow-up. Seventeen patients were alive for 60-1,200 days, and their shunt patency was 71%. There was no significant difference in shunt patency between the two groups with benign and malignant ascites. CONCLUSIONS: The percutaneous placement of a PVS was a technically feasible and effective method for symptomatic relief of refractory ascites.
Authors: Hooman Yarmohammadi; Lynn A Brody; Joseph P Erinjeri; Anne M Covey; F Edward Boas; Etay Ziv; Majid Maybody; Adrian J Gonzalez-Aguirre; Karen T Brown; Joel Sheinfeld; George I Getrajdman Journal: J Vasc Interv Radiol Date: 2016-03-07 Impact factor: 3.464
Authors: Hooman Yarmohammadi; Juliana Schilsky; Jeremy C Durack; Lynn A Brody; Ulrika Asenbaum; Sara Velayati; Ernesto Santos; Adrian J Gonzalez-Aguirre; Joseph P Erinjeri; Nadia Petre; Stephen B Solomon; Joel Sheinfeld; George I Getrajdman Journal: J Urol Date: 2020-05-05 Impact factor: 7.600