Therapeutic efficacy and stent patency of transhepatic portal vein stenting after surgery. 2016

Ung Bae Jeon, and Chang Won Kim, and Tae Un Kim, and Ki Seok Choo, and Joo Yeon Jang, and Kyung Jin Nam, and Chong Woo Chu, and Je Ho Ryu
Ung Bae Jeon, Tae Un Kim, Ki Seok Choo, Joo Yeon Jang, Kyung Jin Nam, Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam 626-770, South Korea.

OBJECTIVE To evaluate portal vein (PV) stenosis and stent patency after hepatobiliary and pancreatic surgery, using abdominal computed tomography (CT). METHODS 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. RESULTS 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. CONCLUSIONS 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.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010690 Phlebography Radiographic visualization or recording of a vein after the injection of contrast medium. Venography,Phlebographies,Venographies
D011169 Portal Vein A short thick vein formed by union of the superior mesenteric vein and the splenic vein. Portal Veins,Vein, Portal,Veins, Portal
D011172 Portography Examination of the portal circulation by the use of X-ray films after injection of radiopaque material. Splenoportography,Portographies,Splenoportographies
D003251 Constriction, Pathologic The condition of an anatomical structure's being constricted beyond normal dimensions. Stenosis,Stricture,Constriction, Pathological,Pathologic Constriction,Constrictions, Pathologic,Pathologic Constrictions,Pathological Constriction,Stenoses,Strictures
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072226 Computed Tomography Angiography A non-invasive method that uses a CT scanner for capturing images of blood vessels and tissues. A CONTRAST MATERIAL is injected, which helps produce detailed images that aid in diagnosing VASCULAR DISEASES. Angiography, CT,Angiography, Computed Tomography,CT Angiography,Angiographies, CT,Angiographies, Computed Tomography,CT Angiographies,Computed Tomography Angiographies,Tomography Angiographies, Computed,Tomography Angiography, Computed
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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