Interventional recanalization therapy in patients with non-cirrhotic, non-malignant portal vein thrombosis: comparison between transjugular versus transhepatic access.
Purpose: To compare the safety and outcome of transjugular versus percutaneous technique in recanalization of non-cirrhotic, non-malignant portal vein thrombosis. Methods: We present a retrospective bicentric analysis of 21 patients with non-cirrhotic, non-malignant PVT, who were treated between 201...
| Publicado en: | Abdominal Radiology Vol. 47; no. 3; pp. 1177 - 1187 |
|---|---|
| Autores principales: | , , , , , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Springer Nature
Mar2022
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=155380775&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 155380775 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 2366004X JT14 jtl: Abdominal Radiology issn: 2366004X maglogo: N pubinfo: dt: Mar2022 vid: 47 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 155380775 154633816 155380775 155380775 10.1007/s00261-022-03411-w 155380775 ppf: 1177 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Interventional recanalization therapy in patients with non-cirrhotic, non-malignant portal vein thrombosis: comparison between transjugular versus transhepatic access. aug: au: Mansour, Nabeel Öcal, Osman Gerwing, Mirjam Köhler, Michael Deniz, Sinan Heinzow, Hauke Steib, Christian Angele, Martin K. Seidensticker, Max Ricke, Jens Wildgruber, Moritz affil: Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany sug: subj: Portal Vein Pathology Venous Thrombosis Surgery Embolization, Therapeutic Methods Radiography, Interventional Methods Treatment Outcomes Evaluation Human Adult Middle Age Aged Retrospective Design Record Review Portasystemic Shunt, Surgical Methods Postoperative Complications Blood Loss, Surgical Descriptive Statistics Multivariate Analysis Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years ab: Purpose: To compare the safety and outcome of transjugular versus percutaneous technique in recanalization of non-cirrhotic, non-malignant portal vein thrombosis. Methods: We present a retrospective bicentric analysis of 21 patients with non-cirrhotic, non-malignant PVT, who were treated between 2016 and 2021 by interventional recanalization via different access routes (percutaneous [PT] vs. transjugular in transhepatic portosystemic shunt [TIPS] technique). Complication rates with a focus on periprocedural bleeding and patency as well as outcome were compared. Results: Of the 21 patients treated (median age 48 years, range of 19–78), seven (33%) patients had an underlying prothrombotic condition. While 14 (57%) patients were treated for acute PVT, seven (43%) patients had progressive thrombosis with known chronic PVT. Nine patients underwent initial recanalization via PT access and twelve via TIPS technique. There was no significant difference in complete technical success rate according to initial access route (55.5% in PT group vs. 83.3% in TIPS group, p = 0.331). However, creation of an actual TIPS was associated with higher technical success in restoring portal venous flow (86.6% vs. 33.3%, p = 0.030). 13 (61.9%) patients received thrombolysis. Nine (42.8%) patients experienced hemorrhagic complications. In a multivariate analysis, thrombolysis (p = 0.049) and PT access as the first procedure (p = 0.045) were significant risk factors for bleeding. Conclusion: Invasive recanalization of the portal vein in patients with PVT and absence of cirrhosis and malignancy offers a good therapeutic option with high recanalization and patency rates. Bleeding complications result predominantly from a percutaneous access and high amounts of thrombolytics used; therefore, recanalization via TIPS technique should be favored. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|