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Improved Patency of Transjugular Intrahepatic Portosystemic Shunt: The Efficacy of Cilostazol for the Prevention of Pseudointimal Hyperplasia in Swine TIPS Models

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Abstract

Purpose

To investigate the efficacy of oral administration of cilostazol to inhibit pseudointimal/intimal hyperplasia in swine TIPS models.

Methods

Successful TIPS creation was carried out in 11 of 12 healthy young pigs (20–25 kg). In the treatment group (n = 6), both cilostazol and aspirin were administered daily, from the first day of TIPS creation. The control group (n = 5) was administered only aspirin. The animals were followed-up for 2 weeks and then killed. The specimen (including portal vein, hepatic parenchymal tract, hepatic vein, and inferior vena cava) and stents were carefully bisected in a longitudinal fashion. The control group was compared with the treatment group by means of a gross and histologic evaluation of the degree of pseudointimal/intimal hyperplasia in the shunt.

Results

At the gross evaluation, the control group showed considerably more pseudointimal/intimal hyperplasia than the treatment group. Using microscopic evaluation, there was a statistically significant difference (p < 0.05) in the mean maximum pseudointimal/intimal hyperplasia thickness between the control group (2.97 ± 0.33 mm) and treatment group (0.73 ± 0.27 mm).

Conclusion

Oral administration of cilostazol may have been effective in reducing pseudointimal/intimal hyperplasia in swine TIPS models.

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Acknowledgments

The authors are grateful to I.H. Choi, S.O. Kim, and H.D. Lim from Korea University Guro hospital for skilled assistance with the study. This study was supported by Konkuk University in 2004.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea

    Sang Woo Park, Hae Jeong Jeon & Jeong Hee Park

  2. Department of Diagnostic Radiology, Korea University Guro Hospital, Korea University School of Medicine, Seoul, Korea

    In Ho Cha & Suk Joo Hong

  3. Department of Pathology, Korea University Hospital, Korea University School of Medicine, Seoul, Korea

    Chul Hwan Kim

  4. Department of Rehabilitation Medicine, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea

    In Sik Lee

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  1. Sang Woo Park
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  2. In Ho Cha
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Correspondence to Sang Woo Park.

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Park, S.W., Cha, I.H., Kim, C.H. et al. Improved Patency of Transjugular Intrahepatic Portosystemic Shunt: The Efficacy of Cilostazol for the Prevention of Pseudointimal Hyperplasia in Swine TIPS Models. Cardiovasc Intervent Radiol 30, 719–724 (2007). https://doi.org/10.1007/s00270-007-9001-1

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