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Interventional radiological management of prehepatic obstruction the splanchnic venous system

Semiz-Oysu, Aslihan; Keussen, Inger LU and Cwikiel, Wojciech LU (2007) In CardioVascular and Interventional Radiology 30(4). p.688-695
Abstract
The purpose of this study was to retrospectively evaluate interventional radiological management of patients with symptomatic portal hypertension secondary to obstruction of splanchnic veins. Twenty-four patients, 15 males and 9 females, 0.75 to 79 years old (mean, 36.4 years), with symptomatic portal hypertension, secondary to splanchnic venous obstruction, were treated by percutaneous methods. Causes and extent of splanchnic venous obstruction and methods are summarized following a retrospective evaluation. Obstructions were localized to the main portal vein (n = 22), intrahepatic portal veins (n = 8), splenic vein (n = 4), and/or mesenteric veins (n = 4). Interventional treatment of 22 (92%) patients included recanalization (n = 19),... (More)
The purpose of this study was to retrospectively evaluate interventional radiological management of patients with symptomatic portal hypertension secondary to obstruction of splanchnic veins. Twenty-four patients, 15 males and 9 females, 0.75 to 79 years old (mean, 36.4 years), with symptomatic portal hypertension, secondary to splanchnic venous obstruction, were treated by percutaneous methods. Causes and extent of splanchnic venous obstruction and methods are summarized following a retrospective evaluation. Obstructions were localized to the main portal vein (n = 22), intrahepatic portal veins (n = 8), splenic vein (n = 4), and/or mesenteric veins (n = 4). Interventional treatment of 22 (92%) patients included recanalization (n = 19), pharmacological thrombolysis (n = 1), and mechanical thrombectomy (n = 5). Partial embolization of the spleen was done in five patients, in two of them as the only possible treatment. TIPS placement was necessary in 10 patients, while an existing occluded TIPS was revised in two patients. Transhepatic embolization of varices was performed in one patient, and transfemoral embolization of splenorenal shunt was performed in another. Thirty-day mortality was 13.6% (n=3). During the follow-up, ranging between 2 days and 58 months, revision was necessary in five patients. An immediate improvement of presenting symptoms was achieved in 20 patients (83%). We conclude that interventional procedures can be successfully performed in the majority of patients with obstruction of splanchnic veins, with subsequent improvement of symptoms. Treatment should be customized according to the site and nature of obstruction. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bleeding, portal hypertension, gastroesophageal varices, TIPS, recanalization, occlusion, thrombosis, portal vein, splanchnic veins
in
CardioVascular and Interventional Radiology
volume
30
issue
4
pages
688 - 695
publisher
Springer
external identifiers
  • wos:000248831000017
  • scopus:36049005278
ISSN
1432-086X
DOI
10.1007/s00270-007-9097-3
language
English
LU publication?
yes
id
11ba651a-0ffe-4747-a586-8a8dcd2d4e9c (old id 689590)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/17587082
http://link.springer.com/article/10.1007/s00270-007-9097-3/fulltext.html
date added to LUP
2008-01-02 15:11:29
date last changed
2017-08-20 03:47:51
@article{11ba651a-0ffe-4747-a586-8a8dcd2d4e9c,
  abstract     = {The purpose of this study was to retrospectively evaluate interventional radiological management of patients with symptomatic portal hypertension secondary to obstruction of splanchnic veins. Twenty-four patients, 15 males and 9 females, 0.75 to 79 years old (mean, 36.4 years), with symptomatic portal hypertension, secondary to splanchnic venous obstruction, were treated by percutaneous methods. Causes and extent of splanchnic venous obstruction and methods are summarized following a retrospective evaluation. Obstructions were localized to the main portal vein (n = 22), intrahepatic portal veins (n = 8), splenic vein (n = 4), and/or mesenteric veins (n = 4). Interventional treatment of 22 (92%) patients included recanalization (n = 19), pharmacological thrombolysis (n = 1), and mechanical thrombectomy (n = 5). Partial embolization of the spleen was done in five patients, in two of them as the only possible treatment. TIPS placement was necessary in 10 patients, while an existing occluded TIPS was revised in two patients. Transhepatic embolization of varices was performed in one patient, and transfemoral embolization of splenorenal shunt was performed in another. Thirty-day mortality was 13.6% (n=3). During the follow-up, ranging between 2 days and 58 months, revision was necessary in five patients. An immediate improvement of presenting symptoms was achieved in 20 patients (83%). We conclude that interventional procedures can be successfully performed in the majority of patients with obstruction of splanchnic veins, with subsequent improvement of symptoms. Treatment should be customized according to the site and nature of obstruction.},
  author       = {Semiz-Oysu, Aslihan and Keussen, Inger and Cwikiel, Wojciech},
  issn         = {1432-086X},
  keyword      = {bleeding,portal hypertension,gastroesophageal varices,TIPS,recanalization,occlusion,thrombosis,portal vein,splanchnic veins},
  language     = {eng},
  number       = {4},
  pages        = {688--695},
  publisher    = {Springer},
  series       = {CardioVascular and Interventional Radiology},
  title        = {Interventional radiological management of prehepatic obstruction the splanchnic venous system},
  url          = {http://dx.doi.org/10.1007/s00270-007-9097-3},
  volume       = {30},
  year         = {2007},
}