Percutaneous transsplenic access in the management of bleeding varices from chronic portal vein thrombosis.
Three patients with life-threatening variceal hemorrhage secondary to portal vein (PV) thrombosis underwent endovascular treatment via the transsplenic route. The indications, techniques, and early outcomes are described. Each patient had successful portal/splenic vein recanalization with or without transjugular intrahepatic portosystemic shunt (TIPS) creation and variceal embolization with conventional catheter and wire techniques. The transsplenic approach is a useful addition to the interventional armamentarium that can be used in cases refractory to endoscopic management and unsuitable for surgical shunt procedures or conventional TIPS procedures. Longer-term follow-up will be needed to establish the durability of these procedures.
Department of Vascular and Interventional Radiology, St. James's University Teaching Hospital, Beckett Street, Leeds, LS9 7TF, United Kingdom. davidtuite@yahoo.co.uk
David J
DJ
Tuite
Jay
J
Rehman
Mervin H
MH
Davies
Jai V
JV
Patel
Anthony A
AA
Nicholson
David O
DO
Kessel
D000328:Adult; D002908:Chronic Disease; D004621:Embolization, Therapeutic; D004932:Esophageal and Gastric Varices / Q000209:etiology* / Q000628:therapy*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011172:Portography; D015641:Radiography, Interventional; D013154:Spleen; D015607:Stents; D018084:Ultrasonography, Interventional; D020246:Venous Thrombosis / Q000150:complications*