Therapeutic efficacy and stent patency of transhepatic portal vein stenting after surgery
| Autor: | Ung Bae Jeon, Tae Un Kim, Ki Seok Choo, Kyung Jin Nam, Joo Yeon Jang, Changwon Kim, Chong Woo Chu, Je Ho Ryu |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Time Factors Percutaneous Computed Tomography Angiography medicine.medical_treatment Vein Constriction Pathologic Kaplan-Meier Estimate Stent patency 030218 nuclear medicine & medical imaging 0302 clinical medicine Stent Computed tomography Digestive System Surgical Procedures Surveillance medicine.diagnostic_test Portal Vein Gastroenterology General Medicine Middle Aged Portal Pressure Efficace Treatment Outcome surgical procedures operative medicine.anatomical_structure Liver 030220 oncology & carcinogenesis Female Stents Radiology Adult medicine.medical_specialty 03 medical and health sciences Retrospective Study medicine Humans Vascular Diseases cardiovascular diseases Superior mesenteric vein Portography Vascular Patency Aged Retrospective Studies business.industry Phlebography equipment and supplies medicine.disease Surgery Stenosis Splenic vein business Angioplasty Balloon |
| Zdroj: | World Journal of Gastroenterology |
| ISSN: | 1007-9327 |
| Popis: | Aim 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. Conclusion 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. |
| Databáze: | OpenAIRE |
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