title: Safety and Efficacy of Irradiation Stent Placement for Malignant Portal Vein Thrombus Combined with Transarterial Chemoembolization for Hepatocellular Carcinoma: A Single-Center Experience.
abstract: OBJECTIVE
  To assess feasibility, safety, and preliminary efficacy of an irradiation portal vein stent for portal vein tumor thrombosis (PVTT) in patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  Between October 2012 and September 2015, 25 of 40 patients (mean age of 55.5 y) with PVTT caused by HCC were recruited for treatment with an irradiation portal vein stent (self-expandable stent loaded with iodine-125 seeds) at a single hospital. Liver function was classified as Child-Pugh class A in 15 patients (60%) and class B in 10 patients (40%). The Eastern Cooperative Oncology Group performance status score was 0 in 3 patients (12%), 1 in 13 patients (52%), and 2 in 9 patients (36%). Transarterial chemoembolization was performed after stent placement. Outcomes were measured in terms of technical success, complications, stent patency, and overall survival.
  
  
  RESULTS
  The technical success rate was 92.0% (23/25). No complications grade 3 or higher according to Common Terminology Criteria for Adverse Events were observed. Median stent patency period was 8.0 months (range, 0.6-30.0 months). Between 7 and 955 days after stent placement, 65 cycles of transarterial chemoembolization were performed with a mean of 2.8 cycles per patient. Median survival was 12.5 months (range, 0.6-35.7 months).
  
  
  CONCLUSIONS
  Placement of an irradiation portal vein stent appears feasible and safe and may prolong the patency of the portal vein. It is a promising technique for combining recanalization of an occluded portal vein and brachytherapy.
authors.affiliation: Department of Radiology, Zhong-Da Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Radiology, Zhong-Da Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China.
authors.forename: Jin-He
authors.initials: JH
authors.lastname: Guo
authors.affiliation: Department of Radiology, Zhong-Da Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China.
authors.forename: Hai-Dong
authors.initials: HD
authors.lastname: Zhu
authors.affiliation: Department of Radiology, Zhong-Da Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China.
authors.forename: Guang-Yu
authors.initials: GY
authors.lastname: Zhu
authors.affiliation: Department of Radiology, Zhong-Da Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China.
authors.forename: Li
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Radiology, Zhong-Da Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China. Electronic address: gjteng@vip.sina.com.
authors.forename: Gao-Jun
authors.initials: GJ
authors.lastname: Teng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology*; D011446:Prospective Studies; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000473:pathology / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D007457:Iodine Radioisotopes