Takaaki Hasegawa, Presenter: Nothing to Disclose

Haruyuki Takaki MD, Abstract Co-Author: Nothing to Disclose

Atsuhiro Nakatsuka MD, Abstract Co-Author: Nothing to Disclose

Junji Uraki MD, Abstract Co-Author: Nothing to Disclose

Takashi Yamanaka MD, Abstract Co-Author: Nothing to Disclose

Masashi Fujimori MD, Abstract Co-Author: Nothing to Disclose

Hajime Sakuma MD, Abstract Co-Author: Departmental Research Grant, Siemens AG Departmental Research Grant, Koninklijke Philips Electronics NV Departmental Research Grant, General Electric Company Departmental Research Grant, Bayer AG Departmental Research Grant, Eisai Co, Ltd Departmental Research Grant, Guerbet SA

Shuji Isaji, Abstract Co-Author: Nothing to Disclose

Koichiro Yamakado MD, PhD, Abstract Co-Author: Nothing to Disclose

To evaluate clinical outcomes of portal venous stent placement in patients with symptomatic portal hypertension caused by malignant tumor invasion.

From Jury 2005 to January 2013, eleven patients with portal venous stenosis or occlusion caused by bile duct cancer (n=6), pancreatic cancer (n=4), and nodal metastasis from colon cancer (n=1) underwent stent placement because of gastrointestinal bleeding (n=4), ascites (n=4), liver dysfunction (n=2), and hypersplenism (n=1). Stents were placed across the stenotic (n=7) or occluded (n=4) lesions after percutaneous transhepatic portography. Technical success, changes in portal venous pressure, symptoms, complications, stent patency, and survival were evaluated. Complications were evaluated by using Common Terminology Criteria for Adverse Events (CTCAE).

Stent placement was technically successful in all patients (technical success rate: 100%, 11/11). The mean portal venous pressure gradient decreased from 12.6±4.8 mmHg (range, 5-20 mmHg) to 0.5±1.0 mmHg (range, 0-3 mmHg) (p<0.00001) immediately after stent placement. Symptoms were improved in all but one patient who died of pneumonia before improvement of symptom. A grade 3 intraperitoneal bleeding developed in one patient after stent placement (9.1%, 1/11). All stents remained patent during the mean follow up of 0.4-22.9 months (mean, 3.8±6.2 months). The 3- and 6-months survival rate was 54.5% and 9.1%, respectively.

Portal venous stent placement is feasible, safe, and effective technique to relieve symptomatic portal hypertension caused by malignant tumor invasion.

Portal venous stent placement is an effective treatment option for patients with portal hypertension caused by malignant tumor invasion.

Hasegawa, T, Takaki, H, Nakatsuka, A, Uraki, J, Yamanaka, T, Fujimori, M, Sakuma, H, Isaji, S, Yamakado, K, Clinical Efficacy of Portal Venous Stent Placement for Symptomatic Portal Hypertension Caused by Malignant Tumor Invasion.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13019573.html