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Interventional radiologic treatment for idiopathic portal hypertension
S Hirota1, S Ichikawa, S Matsumoto
1Department of Radiology, Kobe University School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City, Japan 650-0017, USA.
Purpose:
To evaluate the usefulness of interventional radiological treatment for idiopathic portal hypertension.
Methods:
Between 1995 and 1998, we performed an interventional radiological treatment in five patients with idiopathic portal hypertension, four of whom had refused surgery and one of whom had undergone surgery. Three patients with gastroesophageal varices (GEV) were treated by partial splenic embolization (PSE), one patient with esophageal varices (EV) and massive ascites by transjugular intrahepatic portosytemic shunt (TIPS) and PSE, and one patient with GEV by percutaneous transhepatic obliteration (PTO). Midterm results were analyzed in terms of the effect on esophageal and/or gastric varices.
Results:
In one woman with severe GEV who underwent three sessions of PSE, there was endoscopic confirmation that the GEV had disappeared. In one man his EV shrunk markedly after two sessions of PSE. In two patients slight reduction of the EV was obtained with one application of PSE combined with endoscopic variceal ligation therapy. PTO for GV in one patient resulted in good control of the varices. All patients have survived for 16-42 months since the first interventional treatment, and varices are well controlled.
Conclusion:
Interventional radiological treatment is effective for patients with idiopathic portal hypertension, whether or not they have undergone surgery.