Hepato-gastroenterology · 2010
Interventional therapy for symptomatic-benign portal vein occlusion.
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Liu Feng-Yong, Wang Mao-Qiang, Duan Feng, Wang Zhi-Jun, Song Peng
Аннотация
BACKGROUND/AIMS: We aimed to evaluate the safety and efficacy of interventional therapy for symptomatic benign portal vein occlusion.
METHODOLOGY: Forty-four patients with symptomatic-benign portal vein occlusion (stenosis, thrombosis) underwent interventional therapy. There were 32 cases of acute-subacute portal vein thrombosis and 12 cases of portal vein anastomotic stricture post-liver transplantation. Eighteen patients were treated through percutaneous transhepatic portal vein branch puncture and 26 through the transjugular intrahepatic portosystemic shunt approach.
RESULTS: All patients received successful interventional therapy, without serious complications. At the end of the treatment, repeat angiography revealed patent portal vein; portal vein trunk lumen residual stenosis was <20% (34 cases) and <40% (8 cases). The patients were followed for 48 months; abdominal imaging examinations and liver function tests were regularly performed and reviewed in combination with patients' self-perceived symptoms. Portal vein thrombus formed again in 3 patients at 1 month, 3 months, and 4 months respectively. All received portal vein thrombolysis again through interventional therapy. In the other 41 patients, repeat ultrasonic examination did not reveal thrombosis recurrence.
CONCLUSIONS: Interventional techniques, including local thrombolysis and mechanical thrombectomy, balloon dilatation, and stent placement, are safe and effective methods for symptomatic-benign portal vein occlusion treatment.
METHODOLOGY: Forty-four patients with symptomatic-benign portal vein occlusion (stenosis, thrombosis) underwent interventional therapy. There were 32 cases of acute-subacute portal vein thrombosis and 12 cases of portal vein anastomotic stricture post-liver transplantation. Eighteen patients were treated through percutaneous transhepatic portal vein branch puncture and 26 through the transjugular intrahepatic portosystemic shunt approach.
RESULTS: All patients received successful interventional therapy, without serious complications. At the end of the treatment, repeat angiography revealed patent portal vein; portal vein trunk lumen residual stenosis was <20% (34 cases) and <40% (8 cases). The patients were followed for 48 months; abdominal imaging examinations and liver function tests were regularly performed and reviewed in combination with patients' self-perceived symptoms. Portal vein thrombus formed again in 3 patients at 1 month, 3 months, and 4 months respectively. All received portal vein thrombolysis again through interventional therapy. In the other 41 patients, repeat ultrasonic examination did not reveal thrombosis recurrence.
CONCLUSIONS: Interventional techniques, including local thrombolysis and mechanical thrombectomy, balloon dilatation, and stent placement, are safe and effective methods for symptomatic-benign portal vein occlusion treatment.