Transjugular Intrahepatic Portosystemic Shunt: Histologic and Immunohistochemical Study of Autopsy Cases
- Department of Radiology, Kanazawa University, School of Medicine, 13-1 Takara machi, Kanazawa 920 (Japan)
- First Department of Internal Medicine, Kanazawa University, School of Medicine, 13-1 Takara machi, Kanazawa 920 (Japan)
- First Department of Pathology, Kanazawa University, School of Medicine, 13-1 Takara machi, Kanazawa 920 (Japan)
- Second Department of Pathology, Kanazawa University, School of Medicine, 13-1 Takara machi, Kanazawa 920 (Japan)
Purpose: To assess the histologic findings associated with stenosed and occluded transjugular intrahepatic portosystemic shunt (TIPS) tracts. Methods: Four TIPS tracts within three autopsy livers were histologically studied for vascular components by routine staining and immunohistochemical staining. TIPS had been performed for bleeding from esophageal varices in patients with cirrhosis of the liver. Results: Two TIPS, examined on days 4 and 53, showed occlusion by fibrin thrombus. In the former, no endothelial cells were detected, but coagulative necrosis of hepatocytes was found in the surrounding liver. In the latter, bile pigments were seen on the luminal surface. In the two other TIPS without tract occlusion, examined on days 49 and 293, a layer of endothelial cells, proliferation of smooth muscle cells, and deposition of an extracellular matrix such as collagen were confirmed. In the tract examined on day 293, there was protrusion of hepatocytes into the lumen through the stent wires. Conclusion: Short- and midterm TIPS occlusions were caused by thrombus forming after necrosis of hepatocytes and bile leakage, respectively. Long-term TIPS stenosis was associated with a combination of pseudointimal hyperplasia and ingrowth of hepatocytes.
- OSTI ID:
- 21080452
- Journal Information:
- Cardiovascular and Interventional Radiology, Vol. 20, Issue 6; Other Information: DOI: 10.1007/s002709900193; Copyright (c) 1997 Springer-Verlag New York Inc; Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
- Country of Publication:
- United States
- Language:
- English
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