AI Summary & Key Takeaways
AI InsightBalloon angioplasty seems less risky foranastomotic ruptures in portal vein stenosis in the early post liver transplantation period.
📌 3 Key Takeaways
Özet
PURPOSEIt 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 adultliver transplant patients.METHODSWe retrospectively reviewed 31 patients with portal vein stenosis among 1369 patients who underwent adult liver transplantation from January 2001 to December 2015. When stenosis wasconfirmed 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 patencyin patients who underwent percutaneous transluminal angioplasty and stent insertion throughregular outpatient follow-up and evaluated technical and clinical success and long-term results.RESULTSTechnical 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. At1, 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 ofpatients 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.CONCLUSIONStent 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 foranastomotic ruptures in portal vein stenosis in the early post liver transplantation period.