Treatment of postoperative main portal vein and superior mesenteric vein thrombosis with balloon angioplasty and/or stent placement. (June 2013)

• Record Type: Journal Article
• Authors: Cao, Guangshao; Ko, Gi-Young; Sung, Kyu-Bo; Yoon, Hyun-Ki; Gwon, Dong Il; Kim, Jin-Hyoung
• Is Part Of: Acta radiologica. Volume 54:Number 5(2013)
• Page Start: 526
• Page End: 532
• Publication Date: 2013-06
• Subjects: Portal vein thrombosis -- balloon angioplasty -- stent; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185113475917
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Thrombolysis and mechanical thrombectomy have been used to treat postoperative main portal vein and superior mesenteric vein thrombosis. Purpose: To evaluate the safety and efficacy of balloon angioplasty and/or stent placement without thrombolysis or thrombectomy for treating such thromboses. Material and Methods: Fourteen patients with postoperative main portal vein or superior mesenteric vein thrombosis underwent percutaneous transhepatic balloon angioplasty and/or stent placement without thrombolysis or thrombectomy. The rates of technical and clinical success, major complications, and recurrence were evaluated retrospectively. Results: Initial technical success was achieved in 13 of the 14 patients (93%). After the procedures, these 13 patients showed brisk portal inflow, without a significant amount of residual thrombus in the stented lumen or embolism. One patient was considered to be a technical failure despite showing a brisk portal inflow because 50% stenosis and partial residual thrombus remained in the stented lumen. Initial clinical success was achieved in 13 patients. One patient with technical success died of acute respiratory distress syndrome 8 days after the procedure, whereas one patient with technical failure achieved clinical success. One patient experienced acute rethrombosis 8 days after the procedure. During the median follow-up period of 16.3 months, rethrombosis occurred in six patients (43%), including one patient with acute rethrombosis. Conclusion: Balloon angioplasty and/or stent placement without thrombolysis or thrombectomy may be a safe and effective treatment modality for postoperative main portal vein and superior mesenteric vein thrombosis.