Abstract
PURPOSE: To evaluate the safety and efficacy of portal reconstruction in patients with symptomatic spleno-mesenteric-portal venous thrombosis. MATERIALS AND METHODS: Portal reconstruction was attempted in 21 patients (seven women, 14 men; mean age, 53.6 years ± 15.2) with chronic thrombosis of the portal vein alone (n = 8), splenic vein alone (n = 3), or portal, mesenteric, and splenic veins (n = 10). Indications for the procedure were bleeding varices (n = 15), ascites (n = 2), hypersplenism (n = 2), and enteropathy (n = 2). Sixteen procedures were started transhepatically and of these seven were converted to a transjugular intrahepatic portosystemic shunt (TIPS) after successful recanalization of the thrombosed vein. In six patients reconstructions were performed using an intrahepatic portal vein as outflow. Five procedures were performed primarily as TIPS. Wallstents dilated to 7-10 mm were used for reconstruction. The mean follow-up period was 15.2 months ± 15.9. RESULTS: Technical success of portal reconstruction was 85.7% (18 of 21). Thirty-day mortality was 14.3% (three of 21) but was not procedural related. The cumulative rates of survival, primary patency, and palliation at 43 months of follow-up were 61.2% ± 13.5%, 63.5% ± 15.3%, and 31.7% ± 15.7%, respectively. Secondary patency was 79.1% ± 13.8%. The only predictor of mortality was the presence of liver disease (P = .001, Cox regression). CONCLUSION: Portal reconstruction is a safe and effective treatment option for patients with symptomatic chronic portal thrombosis. Liver disease predisposes to a higher mortality.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 363-371 |
| Number of pages | 9 |
| Journal | Journal of Vascular and Interventional Radiology |
| Volume | 10 |
| Issue number | 3 |
| State | Published - Mar 1999 |
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Keywords
- Portal vein, stenosis or obstruction
- Portal vein, thrombosis
- Shunts, portosystemic
- Stents and prostheses
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Radiological and Ultrasound Technology
Cite this
Symptomatic spleno-mesenteric-portal venous thrombosis : Recanalization and reconstruction with endovascular stents. / Stein, Moni; Link, Daniel P.
In: Journal of Vascular and Interventional Radiology, Vol. 10, No. 3, 03.1999, p. 363-371.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Symptomatic spleno-mesenteric-portal venous thrombosis
T2 - Recanalization and reconstruction with endovascular stents
AU - Stein, Moni
AU - Link, Daniel P
PY - 1999/3
Y1 - 1999/3
N2 - PURPOSE: To evaluate the safety and efficacy of portal reconstruction in patients with symptomatic spleno-mesenteric-portal venous thrombosis. MATERIALS AND METHODS: Portal reconstruction was attempted in 21 patients (seven women, 14 men; mean age, 53.6 years ± 15.2) with chronic thrombosis of the portal vein alone (n = 8), splenic vein alone (n = 3), or portal, mesenteric, and splenic veins (n = 10). Indications for the procedure were bleeding varices (n = 15), ascites (n = 2), hypersplenism (n = 2), and enteropathy (n = 2). Sixteen procedures were started transhepatically and of these seven were converted to a transjugular intrahepatic portosystemic shunt (TIPS) after successful recanalization of the thrombosed vein. In six patients reconstructions were performed using an intrahepatic portal vein as outflow. Five procedures were performed primarily as TIPS. Wallstents dilated to 7-10 mm were used for reconstruction. The mean follow-up period was 15.2 months ± 15.9. RESULTS: Technical success of portal reconstruction was 85.7% (18 of 21). Thirty-day mortality was 14.3% (three of 21) but was not procedural related. The cumulative rates of survival, primary patency, and palliation at 43 months of follow-up were 61.2% ± 13.5%, 63.5% ± 15.3%, and 31.7% ± 15.7%, respectively. Secondary patency was 79.1% ± 13.8%. The only predictor of mortality was the presence of liver disease (P = .001, Cox regression). CONCLUSION: Portal reconstruction is a safe and effective treatment option for patients with symptomatic chronic portal thrombosis. Liver disease predisposes to a higher mortality.
AB - PURPOSE: To evaluate the safety and efficacy of portal reconstruction in patients with symptomatic spleno-mesenteric-portal venous thrombosis. MATERIALS AND METHODS: Portal reconstruction was attempted in 21 patients (seven women, 14 men; mean age, 53.6 years ± 15.2) with chronic thrombosis of the portal vein alone (n = 8), splenic vein alone (n = 3), or portal, mesenteric, and splenic veins (n = 10). Indications for the procedure were bleeding varices (n = 15), ascites (n = 2), hypersplenism (n = 2), and enteropathy (n = 2). Sixteen procedures were started transhepatically and of these seven were converted to a transjugular intrahepatic portosystemic shunt (TIPS) after successful recanalization of the thrombosed vein. In six patients reconstructions were performed using an intrahepatic portal vein as outflow. Five procedures were performed primarily as TIPS. Wallstents dilated to 7-10 mm were used for reconstruction. The mean follow-up period was 15.2 months ± 15.9. RESULTS: Technical success of portal reconstruction was 85.7% (18 of 21). Thirty-day mortality was 14.3% (three of 21) but was not procedural related. The cumulative rates of survival, primary patency, and palliation at 43 months of follow-up were 61.2% ± 13.5%, 63.5% ± 15.3%, and 31.7% ± 15.7%, respectively. Secondary patency was 79.1% ± 13.8%. The only predictor of mortality was the presence of liver disease (P = .001, Cox regression). CONCLUSION: Portal reconstruction is a safe and effective treatment option for patients with symptomatic chronic portal thrombosis. Liver disease predisposes to a higher mortality.
KW - Portal vein, stenosis or obstruction
KW - Portal vein, thrombosis
KW - Shunts, portosystemic
KW - Stents and prostheses
UR - http://www.scopus.com/inward/record.url?scp=0033014964&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033014964&partnerID=8YFLogxK
M3 - Article
C2 - 10102204
AN - SCOPUS:0033014964
VL - 10
SP - 363
EP - 371
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
SN - 1051-0443
IS - 3
ER -