Therapeutic efficacy and stent patency of transhepatic portal vein stenting after surgery
Open Access
- 1 January 2016
- journal article
- Published by Baishideng Publishing Group Inc. in World Journal of Gastroenterology
- Vol. 22 (44), 9822-9828
- https://doi.org/10.3748/wjg.v22.i44.9822
Abstract
To evaluate portal vein (PV) stenosis and stent patency after hepatobiliary and pancreatic surgery, using abdominal computed tomography (CT). Percutaneous portal venous stenting was attempted in 22 patients with significant PV stenosis (> 50%) - after hepatobiliary or pancreatic surgery - diagnosed by abdominal CT. Stents were placed in various stenotic lesions after percutaneous transhepatic portography. Pressure gradient across the stenotic segment was measured in 14 patients. Stents were placed when the pressure gradient across the stenotic segment was > 5 mmHg or PV stenosis was > 50%, as observed on transhepatic portography. Patients underwent follow-up abdominal CT and technical and clinical success, complications, and stent patency were evaluated. Stent placement was successful in 21 patients (technical success rate: 95.5%). Stents were positioned through the main PV and superior mesenteric vein (n = 13), main PV (n = 2), right and main PV (n = 1), left and main PV (n = 4), or main PV and splenic vein (n = 1). Patients showed no complications after stent placement. The time between procedure and final follow-up CT was 41-761 d (mean: 374.5 d). Twenty stents remained patent during the entire follow-up. Stent obstruction - caused by invasion of the PV stent by a recurrent tumor - was observed in 1 patient in a follow-up CT performed after 155 d after the procedure. The cumulative stent patency rate was 95.7%. Small in-stent low-density areas were found in 11 (55%) patients; however, during successive follow-up CT, the extent of these areas had decreased. Percutaneous transhepatic stent placement can be safe and effective in cases of PV stenosis after hepatobiliary and pancreatic surgery. Stents show excellent patency in follow-up abdominal CT, despite development of small in-stent low-density areas.Keywords
This publication has 22 references indexed in Scilit:
- Portal Vein Venoplasty and Stent Placement in the Nontransplant PopulationJournal of Vascular and Interventional Radiology, 2009
- Management of Portal Venous Complications After Liver TransplantationTechniques in Vascular and Interventional Radiology, 2007
- Early posttransplantation portal vein stenosis following living donor liver transplantation: Percutaneous transhepatic primary stent placementLiver Transplantation, 2007
- Percutaneous Intravascular Stents for Treatment of Portal Venous Stenosis After Liver Transplantation: Midterm ResultsTransplantation Proceedings, 2006
- Percutaneous Angioplasty of Portal Vein Stenosis that Complicates Liver Transplantation: The Mid-Term Therapeutic ResultsKorean Journal of Radiology, 2005
- Long-Term Venous Complications After Full-Size and Segmental Pediatric Liver TransplantationAnnals of Surgery, 2002
- Extrahepatic Portal Venous Stenosis: Treatment with Percutaneous Transhepatic Stent PlacementJournal of Vascular and Interventional Radiology, 1996
- Portal vein stenosis in children with segmental liver transplants: treatment with percutaneous transhepatic venoplasty.American Journal of Roentgenology, 1995
- Percutaneous Transluminal Angioplasty of Venous Anastomotic Stenoses Complicating Liver Transplantation: Intermediate-term ResultsJournal of Vascular and Interventional Radiology, 1994
- Percutaneous Transhepatic Portal Vein Angioplasty and Stent Placement after Liver Transplantation: Early ExperienceJournal of Vascular and Interventional Radiology, 1990