Long-Term Outcome of Portal Vein Stent Placement in Pediatric Liver Transplant Recipients: A Comparison with Balloon Angioplasty

Shim, Dong Jae; Ko, Gi‐Young; Sung, Kyu‐Bo; Gwon, Dong Il; Ko, Heung Kyu

doi:10.1016/j.jvir.2017.11.019

Cited by 26 publications

(63 citation statements)

References 23 publications

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“…5,15 Balloon angioplasty is considered first line treatment. 15,31,32 Balloon size is selected using measurements during portography, typically ranging from 6 to 24 mm in diameter. 3 Inflation across the lesion is performed until waist effacement is achieved.…”

Section: Imaging Workupmentioning

confidence: 99%

“…Most investigators agree that stent placement is reserved for intraprocedural stenosis recoil, or refractory cases in which restenosis occurs within 3 to 6 months. 3,5,15,31,32 Shim et al favored stent placement over angioplasty in the immediate posttransplant period (<4 weeks), for fear of angioplasty inducing a PV tear. 31 When stent placement is required, self-expanding bare metal stents are commonly utilized with sizing 1 to 2 mm larger than the diameter of the prestenotic extrahepatic portal vein(►Fig.…”

Section: Imaging Workupmentioning

confidence: 99%

“…2B). 15,27,[31][32][33] No consensus exists regarding antiplatelet or anticoagulant therapy following stent placement. Several authors advocate for at least 6 months of oral anticoagulation and/or antiplatelet therapy following stent placement.…”

Section: Imaging Workupmentioning

confidence: 99%

“…The authors conclude that angioplasty is first line therapy for PVS. 31 When stent placement is required (refractory or recurrent PVS), patency rates are exceptional. Funaki et al demonstrated a 100% patency rate in 12 patients with PVS stenosis refractory to balloon angioplasty, with a mean follow-up time of 47 months.…”

Section: Treatment Outcomes and Complicationsmentioning

confidence: 99%

“…Stent placement may also impair future surgeries such as retransplantation. 31 In the pediatric population, narrowing at the stent edge due to graft and recipient growth is considered. 5,32 Shin et al recently identified stent placement as an independent risk factor for biliary anastomotic stricture in LDLT, with a 43.2 versus 17.6% incidence in the stent and matched control (nonstented LDLT patients) groups, respectively.…”

Section: Treatment Outcomes and Complicationsmentioning

confidence: 99%

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Portal Venous Interventions after Liver Transplant

Mahon

Molvar

2019

Dig Dis Interv

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Liver transplant (LT) recipients are a challenging patient population when presenting with graft dysfunction or sequelae of portal hypertension. When no medical causes for graft dysfunction are found, a hemodynamically significant vascular lesion is suspected. Although rare, a variety of diseases may arise involving the portal system, which inhibit flow and graft function. Herein, we present a review of portal venous interventions performed in the LT setting, with focus on imaging diagnosis, endovascular treatment techniques, and outcomes. Entities addressed include portal venous stenosis, portal venous thrombosis, and recurrent fibrosis/cirrhosis with sequelae of portal hypertension.

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Section: Imaging Workupmentioning

confidence: 99%

Section: Imaging Workupmentioning

confidence: 99%

Section: Imaging Workupmentioning

confidence: 99%

Section: Treatment Outcomes and Complicationsmentioning

confidence: 99%

Section: Treatment Outcomes and Complicationsmentioning

confidence: 99%

See 3 more Smart Citations

Portal Venous Interventions after Liver Transplant

Mahon

Molvar

2019

Dig Dis Interv

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Long‐term outcome of primary percutaneous stent angioplasty for pediatric posttransplantation portal vein stenosis

Bukova

Funken

Pfister

et al. 2022

Liver Transplantation

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This study aims to evaluate the long-term efficacy and reintervention rate after primary percutaneous portal vein stent angioplasty for portal vein stenosis (PVS) in pediatric liver transplantation (LT) recipients. From 2004 to 2020, a total of 470 pediatric LTs were performed in our center. All cases were screened for interventional PVS treatment and analyzed retrospectively. We identified 44 patients with 46 percutaneous angioplasties for posttransplantation PVS. The median interval from LT to percutaneous catheter intervention was 5 months (16 days-104 months) with a median follow-up (f/u) period after catheter intervention of 5.7 years (2-156 months). In 40 patients, an endovascular stent was placed as primary (n = 38) or secondary (n = 2) intervention. The median age at stent placement was 23 (6-179) months with a median weight of 10 kg (6-46 kg).Technical success and relief of PVS were achieved in all patients irrespective of age or weight. Adverse events occurred peri-interventionally in two patients and were resolved with standard care. All primary portal vein (PV) stents remained patent until the end of f/u. Reinterventions have been successfully performed in 10 patients for suspected or proven restenosis, resulting in a primary patency rate of 75% and an assisted patency rate of 25%. The median time to reintervention was 6.2 years (range 1-10 years). The need for reintervention was independent of age or weight at both transplantation and initial angioplasty as well as of additional risk factors due to portal hypertension. Percutaneous transhepatic PV stent angioplasty in children is safe and effective in all age groups, with excellent long-term patency. Primary stent angioplasty should be considered as first-line treatment for PVS after pediatric LT.

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A biodegradable polymer stent with high radial performance: Potential for treatment of portal vein stenosis

Liu,

Wang,

et al. 2024

Polymers for Advanced Techs

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Biodegradable polymer stents have a wide application prospect in the treatment of vascular stenosis diseases. However, weak radial performance of polymer stents hinders the treatment of the diseases with high demand for radial supporting, such as portal vein stenosis. According to previous research, the constraint mode between monofilaments is a key factor that affects the radial performance of polymer braided stent. In this work, a series of Poly(l‐lactic acid) (PLLA) stents with the elastomer coating were prepared by ultrasonic spraying process to realize the constraints of monofilament cross points. The results are showed that the radial stiffness and peak force of the coated stent are significantly increased, up to 28 and 35 times higher than that of the bare stent. It is found that the cross points are constrained by the coating, which improves the constraining force between the monofilaments resulting in the increase of the radial force during the deformation process. More importantly, the mechanism of action between the radial force of the coated stent and the mechanical performance of elastic coating has been proposed, revealing a significant positive correlation between them. The radial force of the coated stent could be quantitatively regulated by the six‐arm poly(l‐lactide‐co‐ε‐caprolactone) (6SPLCL) coating cross‐linked by Hexamethylene diisocyanate (HDI) in different proportions. Finally, we build a mechanical model of stents and find that there is a consistency between the theoretical curve and the actual curve trend. This provides further research and expands the application scope for improving the radial supporting performance of the biodegradable polymer stent.

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Long-Term Outcome of Portal Vein Stent Placement in Pediatric Liver Transplant Recipients: A Comparison with Balloon Angioplasty

Cited by 26 publications

References 23 publications

Portal Venous Interventions after Liver Transplant

Portal Venous Interventions after Liver Transplant

Long‐term outcome of primary percutaneous stent angioplasty for pediatric posttransplantation portal vein stenosis

A biodegradable polymer stent with high radial performance: Potential for treatment of portal vein stenosis

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