Portal vein angioplasty using a transjugular, intrahepatic approach for treatment of extrahepatic portal vein stenosis after liver transplantation

Symptomatic portal vein stenosis is an uncommon complication after liver transplantation. Portal vein angioplasty has been successfully established for treatment of portal vein stenosis using mesen teric or percutaneous, transhepatic approaches. We herein report on a patient who suffered from varice...

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Bibliographic Details
Published in:Transplant international 2001-01, Vol.14 (1), p.48-51
Main Authors: Glanemann, M., Settmacher, U., Langrehr, J. M., Kling, N., Stange, B., Staffa, G., Bechstein, W.‐O., Neuhaus, P., Hidajat, N.
Format: Article
Language:English
Subjects:
Angioplasty
Angioplasty - methods
Biological and medical sciences
Constriction, Pathologic
Esophageal and Gastric Varices - etiology
Esophageal and Gastric Varices - surgery
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Hypertension, Portal - etiology
Hypertension, Portal - surgery
Liver transplantation
Liver Transplantation - adverse effects
Liver Transplantation - pathology
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
Other diseases. Semiology
Portal Vein - pathology
Portal Vein - surgery
Portal vein stenosis
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Summary:Symptomatic portal vein stenosis is an uncommon complication after liver transplantation. Portal vein angioplasty has been successfully established for treatment of portal vein stenosis using mesen teric or percutaneous, transhepatic approaches. We herein report on a patient who suffered from variceal bleeding due to portal hypertension 3 months after liver transplantation. After successful endoscopic sclerotherapy, an extrahepatic portal vein stenosis was diagnosed, and portal vein angioplasty was considered as primary therapeutic option. Instead of mesenteric or percutaneous, transhepatic approaches, we adopted a transjugular, intrahepatic access to introduce a 14‐mm balloon catheter into the portal vein. Using this technique, angioplasty was successfully performed. After intervention, no further episodes of variceal bleeding occurred. We favour the transjugular, intrahepatic technique for portal vein angioplasty because it does not require general anesthesia, in contrast to the mesenteric approach, and it reduces the risk of intra‐abdominal bleeding, compared to the percutaneous, transhepatic approach.
ISSN:0934-0874
1432-2277
DOI:10.1111/j.1432-2277.2001.tb00009.x