{"id":25882,"date":"2018-03-09T09:17:27","date_gmt":"2018-03-09T09:17:27","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/derivacion-porto-cava-extrahepatica-por-via-percutanea-peps-para-la-descompresion-de-la-hipertension-portal-una-alternativa-al-tips\/"},"modified":"2018-03-09T09:17:27","modified_gmt":"2018-03-09T09:17:27","slug":"derivacion-porto-cava-extrahepatica-por-via-percutanea-peps-para-la-descompresion-de-la-hipertension-portal-una-alternativa-al-tips","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/navarra\/derivacion-porto-cava-extrahepatica-por-via-percutanea-peps-para-la-descompresion-de-la-hipertension-portal-una-alternativa-al-tips\/","title":{"rendered":"Derivaci\u00f3n porto-cava extrahepatica por via percutanea (peps) para la descompresi\u00f3n de la hipertensi\u00f3n portal: una alternativa al tips"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Isabel Vivas P\u00e9rez <\/strong><\/h2>\n<p>Objetivo  estudiar la posibilidad anat\u00f3mica de crear una derivaci\u00f3n percut\u00e1nea extrahep\u00e1tica entre la vena porta principal (vpp) y la vena cava inferior (vci) en pacientes cirr\u00f3ticos y evaluar la factibilidad de este abordaje en un modelo animal.  material y m\u00e9todo  estudios en humanos (eh): se revisaron las tomograf\u00edas computarizadas (tc) de 34 pacientes cirr\u00f3ticos para evaluar la distancia y las estructuras anat\u00f3micas interpuestas entre la vpp yla vci. Para el an\u00e1lisis, la vpp se dividi\u00f3 en tercios superior, medio e inferior. Modelo experimental (me): se realiz\u00f3 el peps en 10 perros beagle colocando una pr\u00f3tesis  \u00aben di\u00e1bolo\u00bb cubiera de poliuretano especialmente dise\u00f1ada para este estudio. Se probaron diferentes abordajes, dispositivos y pr\u00f3tesis.  resultados  eh: la distancia m\u00e1s corta entre la vpp y la vci se encontr\u00f3 en el tercio inferior de la vpp (1.18+-0.6 cm). En el tercio inferior, el m\u00e1s cercano a la confluencia entre las venas espl\u00e9nica y mesent\u00e9rica inferior, era el lugar donde hab\u00eda menos estructuras anat\u00f3micas interpuestas y a este nivel la relaci\u00f3n espacial entre ambas venas resultaba predecible. Me: se realiz\u00f3 una portograf\u00eda directa cateterizando una v\u00e9nula mesent\u00e9rica por medio de una minilaparotom\u00eda y accediendo a la vci a trav\u00e9s de un abordaje yugular. Se avanz\u00f3 una aguja desde la vpp a la vci y se coloc\u00f3 a modo de puente entre ambas venas una pr\u00f3tesis cubierta de poliuretano con morfolog\u00eda en di\u00e1bolo. Seis de los 10 animales fallecieron por sangrado ocurrido por varios intentos de punci\u00f3n durante el procedimiento o por un desplazamiento de la pr\u00f3tesis al movilizar el mesenterio antes de suturar la minilaparotom\u00eda. los 4 perros restantes se mantuvieron con vida durante, 1, 5, 60 and 90 d\u00edas despu\u00e9s del procedimiento.  conclusiones  peps es anat\u00f3micamente posible en pacientes cirr\u00f3ticos. El tercio inferior de la vpp parece ser el lugar m\u00e1s id\u00f3neo para llevar a cavo la<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Derivaci\u00f3n porto-cava extrahepatica por via percutanea (peps) para la descompresi\u00f3n de la hipertensi\u00f3n portal: una alternativa al tips<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Derivaci\u00f3n porto-cava extrahepatica por via percutanea (peps) para la descompresi\u00f3n de la hipertensi\u00f3n portal: una alternativa al tips <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Isabel Vivas P\u00e9rez <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Navarra<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 26\/09\/2003<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li> Bilbao Jauregu\u00edzar Jos\u00e9 Ignacio<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: agustin Caro paton gomez <\/li>\n<li>Jorge  augusto Quiroga vilas (vocal)<\/li>\n<li>Andr\u00e9s Valdivieso l\u00f3pez (vocal)<\/li>\n<li>Fernando Cam\u00fa\u00f1ez alonso (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Isabel Vivas P\u00e9rez Objetivo estudiar la posibilidad anat\u00f3mica de crear una derivaci\u00f3n percut\u00e1nea extrahep\u00e1tica entre la vena [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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