Endovascular transsplenic recanalization with angioplasty and stenting of an occluded main portal vein in an adult liver transplant recipient

Brown, Mason A.; Donahue, Laurence A.; Gueyikian, Sebouh; Hu, JiaHao; Huffman, Steven D.

doi:10.1016/j.radcr.2020.02.026

Cited by 2 publications

(1 citation statement)

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“…If the portal vein is collapsed because of portal vein stenosis or thrombus or if a large amount of ascites is present, puncture itself becomes difficult. 3 , 7 The transmesenteric antegrade access is another option‚ but it requires laparotomy, cannulation to small vessels, and difficulty in continuous drug administration. In contrast, trans-splenic access is an alternative for percutaneous portal vein access without injuring the liver graft.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Direct Puncture of Retropancreatic Splenic Vein and Portal Thrombectomy in a Patient With Liver Transplantation and Simultaneous Splenectomy

Hara

Soyama

Ishimaru

et al. 2022

Transplantation Direct

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Portal vein thrombosis following liver transplantation is generally managed by endovascular treatment. Although several techniques are available for portal venous access, trans-splenic access is of interest because it avoids damage to the liver graft. However, the spleen cannot be punctured to access the portal vein after splenectomy. We herein report a case of portal vein thrombosis following living donor liver transplantation with simultaneous splenectomy successfully treated by percutaneous intervention with direct puncture of the retropancreatic splenic vein. The splenic vein was punctured under computed tomography guidance in the prone position. Portal venography revealed a contrast defect due to a thrombus in the extrahepatic to intrahepatic portal vein. The portal vein was reopened after thrombectomy, and the portal vein thrombosis did not recur for 2 y. The technique and advantages of our approach are described.

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Section: Discussionmentioning

confidence: 99%