关键词: chronic portal vein thrombosis covered stent endovascular reconstruction iatrogenic lesion portal vein stenosis

Mesh : Angioplasty, Balloon / instrumentation Computed Tomography Angiography Constriction, Pathologic Gastrectomy / adverse effects Humans Iatrogenic Disease Male Middle Aged Phlebography / methods Portal Vein / diagnostic imaging physiopathology Portography / methods Prosthesis Design Stents Time Factors Treatment Outcome Vascular Patency Venous Thrombosis / diagnostic imaging etiology physiopathology therapy

来  源:   DOI:10.1177/1538574416674640   PDF(Sci-hub)

Abstract:
Portal vein (PV) thrombosis (PVT) in the absence of liver disease or thrombophilia is rare. We report a 57-year-old male with a history of stage 3 chronic kidney disease who presented at the emergency department 18 months after abdominal surgery with progressive abdominal pain and distention. Computed tomography revealed PVT with multiple collaterals and moderate ascites. He had undergone partial gastrectomy and gastrojejunal anastomosis at an outside facility for gastrointestinal stromal tumors that caused an iatrogenic stenotic lesion in the PV. The patient underwent balloon angioplasty and endovascular deployment of an 8 mm × 100 mm Viabahn covered stent (W. L. Gore and Associates, Flagstaff, Arizona) in the extrahepatic PV via a transhepatic approach; the device allowed complete restoration of prograde portal flow with clinical improvement. At 6 months from the intervention, he remains symptom-free with normal liver function tests and patent endoprosthesis on antiplatelet therapy.
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