Application of percutaneous transluminal sharp recanalization in transjugular intrahepatic portosystemic shunt for patients with chronic portal vein occlusion

Özet

PURPOSEWe aimed to evaluate the feasibility and safety of a modified technique for portal vein recanalization, percutaneous transluminal sharp recanalization (PTSR), when performing transjugularintrahepatic portosystemic shunt (TIPS) for the treatment of chronic portal vein occlusion (CPVO)and portal hypertension.METHODSNine consecutive patients with CPVO and portal hypertension had undergone TIPS and PTSRprocedure after failing in conventional percutaneous catheterization from March 2017 to July2019. Technical success rates, effectiveness, and complications were evaluated. Follow-up of patients’ clinical outcomes and shunt patency were performed periodically. Primary and secondaryshunt patency were analyzed by Kaplan-Meier method.RESULTSThe occluded portal veins were successfully recanalized after failing in conventional percutaneous catheterization, and TIPS procedures were completed in all 9 patients. Two patients sufferedfrom procedure-related complications. A portosystemic pressure gradient <12 mmHg, or a percent reduction of 25% to 50% of baseline, was achieved in all 9 patients after TIPS. During themedian follow-up period of 28 months (range, 9–36 months), 1 patient experienced recurrentascites and the other 8 patients remained asymptomatic. The cumulative rates of primary andsecondary shunt patency were 66.67% and 100%, respectively, at 2 years.CONCLUSIONAs a supplementary method, PTSR is a feasible and safe method for portal vein recanalizationwhen performing TIPS for patients with CPVO and portal hypertension