PERCUTANEOUS THROMBOLYSIS AND STENT PLACEMENT FOR THE TREATMENT OF PORTAL VEIN THROMBOSIS AFTER LIVER TRANSPLANTATION

Abstract

The durable use of percutaneous minimally invasive techniques for the treatment of portal venous thrombosis after liver transplant has not been widely described. This report illustrates two cases in which percutaneous thrombolysis, angioplasty, and endovascular stent placement were successfully used to treat portal vein thrombosis in patients with recent liver transplants. Liver dysfunction was initially manifested by the elevation of liver enzymes or the development of marked ascites and confirmed in both cases by sonography and angiography. The occluded portal vein was accessed by either a transjugular transhepatic puncture or direct transhepatic catheterization. Intraportal thrombolytic infusion, angioplasty, and stent placement were accomplished without complication. At the most recent follow-up, portal vein patency had been maintained for 2.5 and 4.5 years. These results demonstrate the technical feasibility and long-term patency of angioplasty and endovascular stent placement for the treatment of portal vein thrombosis in liver transplant recipients.