首页|Application of transmesenteric vein extrahepatic portosystemic shunt in treatment of symptomatic portal hypertension with cavernous transformation of portal vein

Application of transmesenteric vein extrahepatic portosystemic shunt in treatment of symptomatic portal hypertension with cavernous transformation of portal vein

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  • 国家科技期刊平台
  • NETL
  • NSTL
  • 万方数据
Purpose:To evaluate the feasibility and efficacy of a transmesenteric vein extrahepatic portosystemic shunt(TmEPS)for the treatment of cavernous transformation of the portal vein(CTPV).Materials and methods:The clinical data of 20 patients with CTPV who underwent TmEPS between December 2020 and January 2022 at Henan Provincial People's Hospital were retrospectively collected.The superior mesenteric vein(SMV)trunk was patent or partially occluded in these patients.An extrahepatic portosystemic shunt between the inferior vena cava and the SMV was established using a stent graft through an infraumbilical median lon-gitudinal mini-laparotomy.The technical success,efficacy,and complication rates were evaluated,and the pre-and postoperative SMV pressures were compared.Patients'clinical outcomes and shunt patency were assessed.Results:TmEPS was successfully performed in 20 patients.The initial puncture success rate of the balloon-assisted puncture technique is 95％.The mean SMV pressure decreased from 29.1±2.9 mmHg to 15.6±3.3 mmHg(p＜0.001).All symptoms of portal hypertension resolved.No fatal procedural complications occurred.During the follow-up period,hepatic encephalopathy occurred in two patients.The remaining patients remained asymp-tomatic.All shunts were patent.Conclusions:TmEPS is a feasible,safe,and effective treatment option for patients with CTPV.

Transmesenteric vein extrahepaticportosystemic shuntCavernous transformation of portal veinPortal vein thrombosisPortal hypertensionLiver cirrhosis

Weixiao Li、Mingzhe Cui、Qiang Li、Kewei Zhang、Shuiting Zhai、Tianxiao Li、Cheshire Nick、Xiuling Li、Heng Wang、Yadong Zhu、Danghui Lu、Jiangbo Chen

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Department of Vascular and Endovascular Surgery,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Zhengzhou,Henan Province,China

Department of Medical Imaging Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Zhengzhou,Henan Province,China

Department of Cerebrovascular Disease,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Zhengzhou,Henan Province,China

Department of Vascular Surgery,Royal Brampton and Harefield Hospital,London,UK

Department of Gastroenterology,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Zhengzhou,Henan Province,China

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Henan medical science and Technology research projects

222102310014

2023

10.1016/j.jimed.2023.04.001

介入医学杂志(英文)

介入医学杂志(英文)

ISSN：
年,卷(期)：2023.6(2)
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