Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

Stent insertion and balloon angioplasty for portal vein stenosis after liver transplantation: long-term follow-up results

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Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

Diagn Interv Radiol 2019; 25: 231-237
DOI: 10.5152/dir.2019.18155
Read: 157 Downloads: 16 Published: 03 September 2019

Abstract

PURPOSE

It is not easy to determine whether balloon angioplasty or stenting should be performed in patients with portal vein stenosis after liver transplantation. We aimed to propose appropriate indication by evaluating long-term outcomes of balloon angioplasty and stent insertion in adult liver transplant patients.

 

METHODS

We retrospectively reviewed 31 patients with portal vein stenosis among 1369 patients who underwent adult liver transplantation from January 2001 to December 2015. When stenosis was confirmed by venography, angioplasty was performed first. When there was no flow improvement or pressure gradient was not decreased after angioplasty, stent insertion was performed. We also performed primary stent insertion without angioplasty for diffuse stenosis, kinking, external compression, and near occlusion of portal vein in venography. We assessed patency in patients who underwent percutaneous transluminal angioplasty and stent insertion through regular outpatient follow-up and evaluated technical and clinical success and long-term results.

 

RESULTS

Technical success was 85% and 100% in balloon angioplasty and stent insertion, respectively. Clinical success was achieved in 78% of balloon angioplasties and in 100% of stent insertions. At 1, 5, and 10 years after balloon angioplasty, patency rates were 87%, 82%, and 68% respectively, and the rates of stent patency were all 100%. Portal vein size measured during the operation of patients with and without recurrence were 19±4.2 mm and 19±3.0 mm (P = 0.956), respectively. The balloon size of patients with and without recurrence were 11±1.95 mm and 14±1.66 mm, respectively (P = 0.013), when balloon angioplasty was performed after stenosis diagnosis.

 

CONCLUSION

Stent insertion can be considered when fibrotic changes are expected due to repeated inflammation and when the balloon size to be used is small. Balloon angioplasty seems less risky for anastomotic ruptures in portal vein stenosis in the early post liver transplantation period. 

 

 

You may cite this article as: Kim SK, Kim JM, Lee JS, Choi GS, Cho J, Lee S. Stent insertion and balloon angioplasty for portal vein stenosis after liver transplantation: long-term follow-up results. Diagn Interv Radiol 2019; 25:231-237.

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