title: Clinical efficacy of portal vein stent placement in patients with hepatocellular carcinoma invading the main portal vein.
abstract: OBJECTIVE
  Hepatocellular carcinoma frequently invades the portal veins, and when it invades the main portal vein, the patient's prognosis is extremely poor. This study was undertaken to evaluate the clinical efficacy of stent placement into the portal vein in these patients.
  
  
  METHODS
  Twenty-one patients with hepatocellular carcinoma invading the main portal vein were studied. Stents were placed in the portal veins to compress tumor thrombi after percutaneous transhepatic portography.
  
  
  RESULTS
  Stents were successfully placed in the portal veins in all patients. Portal venous pressure significantly decreased from 25.3 +/- 7.4 mmHg to 22.4 +/- 6.6 mmHg (p < 0.0001) immediately after stent placement, leading to improvement in gastroesophageal varices, melena and ascites. Although a pseudoaneurysm of the hepatic artery related to portal vein puncture developed in one patient, there were no major complications in the other 20 patients. Blood flow through the stent was maintained during the survival period in 15 patients. The mean stent patency period was 12.4 months. Fifteen patients underwent transcatheter arterial chemoembolization without major complications after stent placement. The survival rate was 64.2% at 6 months and 29.2% at 1 and 2 years, respectively. The mean survival period was 13.7 months.
  
  
  CONCLUSIONS
  Stent placement into the portal vein is a relatively safe and feasible procedure. It improves portal hypertension, expands treatment options, and helps to prolong the survival period in patients with hepatocellular carcinoma invading the main portal vein.
authors: Department of Radiology, Mie University School of Medicine, Japan.
authors: K
authors: K
authors: Yamakado
authors: N
authors: N
authors: Tanaka
authors: A
authors: A
authors: Nakatsuka
authors: K
authors: K
authors: Matsumura
authors: K
authors: K
authors: Takase
authors: K
authors: K
authors: Takeda
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001201:Ascites; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000473:pathology*; D016461:Chemoembolization, Therapeutic; D004932:Esophageal and Gastric Varices / Q000628:therapy; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology*; D008297:Male; D008551:Melena; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011169:Portal Vein / Q000473:pathology / Q000601:surgery; D015607:Stents / Q000009:adverse effects; D015996:Survival Rate; D013997:Time Factors; D020246:Venous Thrombosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*