title: Endovascular Reconstruction of Extrahepatic Portal Vein in Noncirrhotic and Nonmalignant Chronic Portal Vein Thrombosis Secondary to an Iatrogenic Stenotic Lesion.
abstract: Portal vein (PV) thrombosis (PVT) in the absence of liver disease or thrombophilia is rare. We report a 57-year-old male with a history of stage 3 chronic kidney disease who presented at the emergency department 18 months after abdominal surgery with progressive abdominal pain and distention. Computed tomography revealed PVT with multiple collaterals and moderate ascites. He had undergone partial gastrectomy and gastrojejunal anastomosis at an outside facility for gastrointestinal stromal tumors that caused an iatrogenic stenotic lesion in the PV. The patient underwent balloon angioplasty and endovascular deployment of an 8 mm × 100 mm Viabahn covered stent (W. L. Gore and Associates, Flagstaff, Arizona) in the extrahepatic PV via a transhepatic approach; the device allowed complete restoration of prograde portal flow with clinical improvement. At 6 months from the intervention, he remains symptom-free with normal liver function tests and patent endoprosthesis on antiplatelet therapy.
authors: 1 Department of Radiology, Section of Inteventional Radiology, Instituto Nacional de Ciencias Medicas y Nutrición "Salvador Zubiran", Mexico City, Mexico.
authors: Manuel
authors: M
authors: Guerrero-Hernandez
authors: 2 Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Medicas y Nutrición "Salvador Zubiran", Mexico City, Mexico.
authors: Carlos A
authors: CA
authors: Hinojosa
authors: 2 Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Medicas y Nutrición "Salvador Zubiran", Mexico City, Mexico.
authors: Javier E
authors: JE
authors: Anaya-Ayala
authors: 2 Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Medicas y Nutrición "Salvador Zubiran", Mexico City, Mexico.
authors: Erika
authors: E
authors: Elenes
authors: 3 Department of Gastroenterology, Instituto Nacional de Ciencias Medicas y Nutrición "Salvador Zubiran", Mexico City, Mexico.
authors: Aldo
authors: A
authors: Torre
mesh_terms: D000800:Angioplasty, Balloon / Q000295:instrumentation; D000072226:Computed Tomography Angiography; D003251:Constriction, Pathologic; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D011172:Portography / Q000379:methods; D011474:Prosthesis Design; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*
keywords: chronic portal vein thrombosis; covered stent; endovascular reconstruction; iatrogenic lesion; portal vein stenosis