[Obstruction of surgical portosystemic shunts in the early postoperative phase: interventional treatment by angioplasty with stent implantation].
OBJECTIVE
Recurrent variceal bleeding in patients treated with surgical porto-systemic shunting is most often due to shunt stenoses or occlusion. Radiological interventional procedures are a possible method of therapy and our experience herein is described in this report.


METHODS
From 1997 to 1999 54 patients with recurrent variceal bleeding were treated with a surgical porto-systemic shunt procedure. Of these early shunt occlusion occurred in 5 patients, which was treated with percutaneous transcatheter techniques.


RESULTS
In only one patient was PTA alone sufficient to reestablish shunt patency, in four patient stent placement was necessary in addition. In the follow-up period 1 patient died 26 month after intervention with (autopsy-proven) patent shunt, in one patient shunt reocclusion occurred after 11 months and in 3 patients the shunt is still patent.


CONCLUSIONS
PTA, if necessary in combination with stent placement, is an attractive alternative method of therapy in case of an early surgical porto-systemic shunt occlusion.
Strunk
H
H
Radiologische Universitätsklinik Bonn Sigmund-Freud-Str. 25 53105 Bonn.
Textor
J
J
König
R
R
Wolff
M
M
Wilhelm
K
K
Schild
H
H
D000328:Adult; D000792:Angiography; D000800:Angioplasty, Balloon; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D012008:Recurrence; D015607:Stents; D016896:Treatment Outcome