title: Therapeutic efficacy and stent patency of transhepatic portal vein stenting after surgery.
abstract: OBJECTIVE
  To evaluate portal vein (PV) stenosis and stent patency after hepatobiliary and pancreatic surgery, using abdominal computed tomography (CT).
  
  
  METHODS
  Percutaneous portal venous stenting was attempted in 22 patients with significant PV stenosis (> 50%) - after hepatobiliary or pancreatic surgery - diagnosed by abdominal CT. Stents were placed in various stenotic lesions after percutaneous transhepatic portography. Pressure gradient across the stenotic segment was measured in 14 patients. Stents were placed when the pressure gradient across the stenotic segment was > 5 mmHg or PV stenosis was > 50%, as observed on transhepatic portography. Patients underwent follow-up abdominal CT and technical and clinical success, complications, and stent patency were evaluated.
  
  
  RESULTS
  Stent placement was successful in 21 patients (technical success rate: 95.5%). Stents were positioned through the main PV and superior mesenteric vein (n= 13), main PV (n= 2), right and main PV (n= 1), left and main PV (n= 4), or main PV and splenic vein (n= 1). Patients showed no complications after stent placement. The time between procedure and final follow-up CT was 41-761 d (mean: 374.5 d). Twenty stents remained patent during the entire follow-up. Stent obstruction - caused by invasion of the PV stent by a recurrent tumor - was observed in 1 patient in a follow-up CT performed after 155 d after the procedure. The cumulative stent patency rate was 95.7%. Small in-stent low-density areas were found in 11 (55%) patients; however, during successive follow-up CT, the extent of these areas had decreased.
  
  
  CONCLUSIONS
  Percutaneous transhepatic stent placement can be safe and effective in cases of PV stenosis after hepatobiliary and pancreatic surgery. Stents show excellent patency in follow-up abdominal CT, despite development of small in-stent low-density areas.
authors.affiliation: Ung Bae Jeon, Tae Un Kim, Ki Seok Choo, Joo Yeon Jang, Kyung Jin Nam, Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam 626-770, South Korea.
authors.forename: Ung Bae
authors.initials: UB
authors.lastname: Jeon
authors.affiliation: Ung Bae Jeon, Tae Un Kim, Ki Seok Choo, Joo Yeon Jang, Kyung Jin Nam, Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam 626-770, South Korea.
authors.forename: Chang Won
authors.initials: CW
authors.lastname: Kim
authors.affiliation: Ung Bae Jeon, Tae Un Kim, Ki Seok Choo, Joo Yeon Jang, Kyung Jin Nam, Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam 626-770, South Korea.
authors.forename: Tae Un
authors.initials: TU
authors.lastname: Kim
authors.affiliation: Ung Bae Jeon, Tae Un Kim, Ki Seok Choo, Joo Yeon Jang, Kyung Jin Nam, Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam 626-770, South Korea.
authors.forename: Ki Seok
authors.initials: KS
authors.lastname: Choo
authors.affiliation: Ung Bae Jeon, Tae Un Kim, Ki Seok Choo, Joo Yeon Jang, Kyung Jin Nam, Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam 626-770, South Korea.
authors.forename: Joo Yeon
authors.initials: JY
authors.lastname: Jang
authors.affiliation: Ung Bae Jeon, Tae Un Kim, Ki Seok Choo, Joo Yeon Jang, Kyung Jin Nam, Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam 626-770, South Korea.
authors.forename: Kyung Jin
authors.initials: KJ
authors.lastname: Nam
authors.affiliation: Ung Bae Jeon, Tae Un Kim, Ki Seok Choo, Joo Yeon Jang, Kyung Jin Nam, Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam 626-770, South Korea.
authors.forename: Chong Woo
authors.initials: CW
authors.lastname: Chu
authors.affiliation: Ung Bae Jeon, Tae Un Kim, Ki Seok Choo, Joo Yeon Jang, Kyung Jin Nam, Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam 626-770, South Korea.
authors.forename: Je Ho
authors.initials: JH
authors.lastname: Ryu
mesh_terms: D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D000072226:Computed Tomography Angiography; D003251:Constriction, Pathologic; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D017082:Portal Pressure; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011172:Portography / Q000379:methods; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014654:Vascular Patency
keywords: Computed tomography; Efficace; Liver; Stent; Surveillance; Vein