serval:BIB_BA2A14C44201
Palliative portal vein stent placement in malignant and symptomatic extrinsic portal vein stenosis or occlusion.
10.1007/s00270-008-9455-9
000266074500011
18956224
Novellas
S.
author
Denys
A.
author
Bize
P.
author
Brunner
P.
author
Motamedi
J.P.
author
Gugenheim
J.
author
Caroli
F.X.
author
Chevallier
P.
author
article
2009
Cardiovascular and Interventional Radiology
1432-086X[electronic]
journal
32
3
462-470
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.
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
eng
60_published
true
University of Lausanne
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