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

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.

• Authors: Guangshao Cao, Gi-Young Ko, Kyu-Bo Sung, Hyun-Ki Yoon, Dong Il Gwon, Jin-Hyoung Kim
• Journal: Acta radiologica (Stockholm, Sweden : 1987) (Acta Radiol) Vol. 54 Issue 5 Pg. 526-32 (Jun 2013) ISSN: 1600-0455 [Electronic] England
• PMID: 23463860 (Publication Type: Journal Article)
• Copyright: © 2013 The Foundation Acta Radiologica.

Topics

• Aged
• Angioplasty, Balloon (methods)
• Female
• Humans
• Male
• Mesenteric Veins
• Middle Aged
• Portal Vein
• Postoperative Complications (therapy)
• Recurrence
• Retrospective Studies
• Stents
• Treatment Outcome
• Vascular Patency
• Venous Thrombosis (therapy)