Document Detail


Portal venous stent placement in patients with pancreatic and biliary neoplasms invading portal veins and causing portal hypertension: initial experience.
MedLine Citation:
PMID:  11425988     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the clinical usefulness of portal venous stent placement in patients with pancreatic or biliary neoplasms invading portal veins and causing portal hypertension. MATERIALS AND METHODS: Thirteen patients underwent portal venous stent placement because of gastrointestinal bleeding (n = 8), risk of gastroesophageal varix rupture (n = 4), ascites (n = 4), thrombocytopenia (n = 3), and/or portal venous thrombosis (n = 3). The main portal vein or both the intrahepatic and main portal veins were invaded in six patients (group A). The main portal vein and splanchnic veins were involved in seven patients (group B). Stents were placed across the stenotic (n = 8) or occluded (n = 5) lesions after percutaneous transhepatic portography. Changes in portal venous pressure, stent patency, and survival were evaluated. RESULTS: Mean portal venous pressure decreased significantly immediately after stent placement, from 24.9 mm Hg +/- 5.9 (SD) to 15.8 mm Hg +/- 4.6 (P <.001). In group A, blood flow through the stent was maintained and the symptoms had subsided at follow-up (mean, 12.5 months). In group B, symptoms were improved in five patients, but the stents were occluded in all but one patient at a mean follow-up of 1.5 months. There was a significant difference in stent patency between the patients with (14%) and those without (100%) splanchnic venous involvement (P <.01). CONCLUSION: Stent placement helped to relieve portal hypertension symptoms. Splanchnic venous involvement was associated with worse stent patency.
Authors:
K Yamakado; A Nakatsuka; N Tanaka; A Fujii; S Isaji; Y Kawarada; K Takeda
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Radiology     Volume:  220     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-06-26     Completed Date:  2001-07-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  150-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. yama@clin.medic.mie-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Bile Duct Neoplasms / complications*,  diagnosis
Cholestasis, Extrahepatic / complications*,  diagnosis
Female
Follow-Up Studies
Humans
Hypertension, Portal / etiology*,  therapy*
Male
Middle Aged
Neoplasm Invasiveness
Pancreatic Neoplasms / complications*,  diagnosis
Portal Vein / pathology,  radiography
Portography
Probability
Stents*
Treatment Outcome
Vascular Patency

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