Transsplenic endovascular therapy of portal vein stenosis and subsequent complete portal vein thrombosis in a 2-year-old child.
A complex catheter intervention for portal vein stenosis and subsequent complete thrombosis after split-liver transplantation was performed using transsplenic access to the portal vein circulation. The combination of intrahepatic, local thrombolysis and extrahepatic portal vein angioplasty performed twice on 2 consecutive days followed by anticoagulation with a high dose of heparin and clopidogrel completely resolved portal vein stenosis and thrombosis. Postinterventional angiographic and serial ultrasound examinations confirmed that the endovascular therapy was successful. In selected patients, percutaneous transsplenic access to the portal vein circulation may be used for diagnostic and therapeutic interventions even in early childhood.
Bertram
Harald
H
Department of Pediatric Cardiology and Pediatric Intensive Care, Hannover Medical School, Hannover, Germany. bertram.harald@mh-hannover.de
Pfister
Eva-Doreen
ED
Becker
Thomas
T
Schoof
Stephan
S
D017130:Angioplasty; D000925:Anticoagulants / Q000627:therapeutic use; D002675:Child, Preschool; D003251:Constriction, Pathologic; D057510:Endovascular Procedures; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D010690:Phlebography; D011169:Portal Vein / Q000000981:diagnostic imaging; D013162:Splenic Vein / Q000000981:diagnostic imaging; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014652:Vascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
D000925:Anticoagulants