Interventional therapy for symptomatic-benign portal vein occlusion

We aimed to evaluate the safety and efficacy of interventional therapy for symptomatic benign portal vein occlusion.

Forty-four patients with symptomatic-benign portal vein occlusion (stenosis, thrombosis) underwent interventional therapy. There were 32 cases of acute-subacute portal vein thrombosis and 12 cases of portal vein anastomotic stricture post-liver transplantation. Eighteen patients were treated through percutaneous transhepatic portal vein branch puncture and 26 through the transjugular intrahepatic portosystemic shunt approach.

All patients received successful interventional therapy, without serious complications. At the end of the treatment, repeat angiography revealed patent portal vein; portal vein trunk lumen residual stenosis was <20% (34 cases) and <40% (8 cases). The patients were followed for 48 months; abdominal imaging examinations and liver function tests were regularly performed and reviewed in combination with patients' self-perceived symptoms. Portal vein thrombus formed again in 3 patients at 1 month, 3 months, and 4 months respectively. All received portal vein thrombolysis again through interventional therapy. In the other 41 patients, repeat ultrasonic examination did not reveal thrombosis recurrence.

Interventional techniques, including local thrombolysis and mechanical thrombectomy, balloon dilatation, and stent placement, are safe and effective methods for symptomatic-benign portal vein occlusion treatment.