Portal vein stent for symptomatic malignant portal vein stenosis: A single-center experience

Abstract

Objective: Malignant tumors around the portal vein (PV) can cause PV stenosis, and PV stent (PVS) placement may reduce symptoms. This study aimed to investigate the efficacy and safety of PVS for symptomatic malignant PV stenosis.

Methods: Fourteen consecutive patients who underwent percutaneous transhepatic PVS placement from January 2016 to August 2018 for symptomatic malignant PV stenosis were included. Medical records were retrospectively reviewed for procedure-related complications, symptom relief, and stent patency duration after PVS.

Results: Of 14 patients, 7 (50%) were men (median age, 67.5 [range 32-76] years). The most common primary cancer site was the pancreas (57%). PVS placement and complete stent expansion were successful in 13 (93%) patients. PV stenosis-related symptoms were resolved in most patients, 13 of 14 (93%). There was a significant decline in median PV pressure gradient across the stenotic lesions. Postprocedural complications included 1 case (7%) each of hemothorax, intrahepatic PV thrombosis, and liver abscess. With a median follow-up of 114 (range 25-260) days, stent occlusion occurred in 5 patients (36%). The median stent patency duration was 201 days, and the overall survival was 117 days.

Conclusions: PVS placement is a safe and effective method for relieving the symptom of of malignant PV stenosis.

Keywords: Ascites; Cancer; Portal hypertension; Portal vein; Stenosis; Stent.