title: Percutaneous segmental dilatation of portal stenosis after paediatric liver transplantation to avoid or postpone surgery: two cases and literature review.
abstract: OBJECTIVE
  The authors retrospectively reviewed the results obtained with percutaneous treatment of portal stenosis.
  
  
  METHODS
  In November 2005 and March 2008, two patients, 15 and 32 months old, underwent portal vein angioplasty at our centre. Both procedures were performed after ultrasound-guided portal vein puncture and measurement of pre- and postanastomotic pressure gradients. The diameters of the angioplasty catheters ranged from 5 to 10 mm and no stents were used.
  
  
  RESULTS
  In both cases, it was possible to cross the stenoses, perform angioplasty and obtain an immediate reduction of the pressure gradients. There were no major complications after the procedure. In the first patient, percutaneous treatment allowed us to postpone surgical revision of the anastomosis; in the second case, angioplasty had to be repeated twice over a period of 4 years to finally achieve regular patency of the anastomosis and function of the graft.
  
  
  CONCLUSIONS
  Percutaneous treatment of portal stenosis after paediatric liver transplantation is a safe and feasible treatment; if balloon dilatation does not guarantee functional recovery of the organ, it allows surgical revision to be postponed to a later date when the clinical condition is more stable.
authors.affiliation: Department of Surgical Sciences, Radiology Institute, University of Torino, AO Città della Salute e della Scienza, S. Giovanni Battista of Torino, Via Genova 3, 10126, Turin, Italy. paolo.fonio@unito.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Fonio
authors.affiliation: Department of Surgical Sciences, Radiology Institute, University of Torino, AO Città della Salute e della Scienza, S. Giovanni Battista of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Dorigo
authors.initials: D
authors.lastname: Righi
authors.affiliation: Department of Surgical Sciences, Radiology Institute, University of Torino, AO Città della Salute e della Scienza, S. Giovanni Battista of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Discalzi
authors.affiliation: Department of Surgical Sciences, Radiology Institute, University of Torino, AO Città della Salute e della Scienza, S. Giovanni Battista of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Calandri
authors.affiliation: Department of Surgical Sciences, Radiology Institute, University of Torino, AO Città della Salute e della Scienza, S. Giovanni Battista of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Faletti
authors.affiliation: Department of Surgical Sciences, Liver Transplant Center "E.Curtoni", University of Torino, AO Città della Salute e della Scienza, S. Giovanni Battista of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Brunati
authors.affiliation: Department of Surgical Sciences, Radiology Institute, University of Torino, AO Città della Salute e della Scienza, S. Giovanni Battista of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gandini
mesh_terms: D017130:Angioplasty / Q000379:methods; D003251:Constriction, Pathologic / Q000601:surgery; D004106:Dilatation / Q000379:methods; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D011169:Portal Vein / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors