Palliative portal vein stent placement in malignant and symptomatic extrinsic portal vein stenosis or occlusion.

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Serval ID
serval:BIB_BA2A14C44201
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Palliative portal vein stent placement in malignant and symptomatic extrinsic portal vein stenosis or occlusion.
Journal
Cardiovascular and Interventional Radiology
Author(s)
Novellas S., Denys A., Bize P., Brunner P., Motamedi J.P., Gugenheim J., Caroli F.X., Chevallier P.
ISSN
1432-086X[electronic]
Publication state
Published
Issued date
2009
Volume
32
Number
3
Pages
462-470
Language
english
Abstract
This article evaluates the results of portal vein (PV) stent placement in patients with malignant extrinsic lesions stenosing or obstructing the PV and causing symptomatic PV hypertension (PVHT). Fourteen patients with bile duct cancer (n = 7), pancreatic adenocarcinoma (n = 4), or another cancer (n = 3) underwent percutaneous transhepatic portal venous stent placement because of gastroesophageal or jejunal varices (n = 9), ascites (n = 7), and/or thrombocytopenia (n = 2). Concurrent tumoral obstruction of the main bile duct was treated via the transhepatic route in the same session in four patients. Changes in portal venous pressure, complications, stent patency, and survival were evaluated. Mean +/- standard deviation (SD) gradient of portal venous pressure decreased significantly immediately after stent placement from 11.2 mmHg +/- 4.6 to 1.1 mmHg +/- 1.0 (P < 0.00001). Three patients had minor complications, and one developed a liver abscess. During a mean +/- SD follow-up of 134.4 +/- 123.3 days, portal stents remained patent in 11 patients (78.6%); stent occlusion occurred in 3 patients, 2 of whom had undergone previous major hepatectomy. After stent placement, PVHT symptoms were relieved in four (57.1%) of seven patients who died (mean survival, 97 +/- 71.2 days), and relieved in six (85.7%) of seven patients still alive at the end of follow-up (mean follow-up, 171.7 +/- 153.5 days). Stent placement in the PV is feasible and relatively safe. It helped to relieve PVHT symptoms in a single session.
Keywords
Adenocarcinoma/complications, Adenocarcinoma/therapy, Adult, Aged, Bile Duct Neoplasms/complications, Bile Duct Neoplasms/therapy, Constriction, Pathologic/complications, Constriction, Pathologic/therapy, Female, Humans, Hypertension, Portal/etiology, Hypertension, Portal/therapy, Male, Middle Aged, Palliative Care, Pancreatic Neoplasms/complications, Pancreatic Neoplasms/therapy, Portal Vein, Stents, Survival Rate, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
16/06/2009 16:18
Last modification date
01/10/2019 6:19
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