Splanchnic vein reconstruction using dedicated venous stents

Dedicated venous stents are designed for use in iliofemoral and thoracic central veins. This report describes the feasibility of deploying these stents in the splanchnic veins.

A retrospective review of patients who underwent main portal, splenic, and/or mesenteric vein reconstruction using dedicated venous stents was performed. Technical success of stent deployment within the intended splanchnic vein(s) and clinical success of improvement in presenting symptoms of splanchnic venous obstruction were assessed. Stent patency was evaluated using contrast-enhanced computed tomography and/or Doppler ultrasound.

Twenty-two patients (12 men, 10 women; mean age, 56 years) were identified. The presenting symptoms included abdominal pain in 12 (55%), ascites in 11 (50%), and variceal hemorrhage in six (27%) patients. Twenty Abre Venous Stents (77%) and six Venovo Venous Stent Systems (23%) were placed in the main portal (n = 19), superior mesenteric (n = 10), and splenic (n = 8) veins. Technical success was achieved in 22 patients (100%). Clinical success was achieved in 17 patients (77%). Follow-up imaging was obtained in 19 patients (86%). The latest available studies occurred at a median of 110 days (range, 7-1091 days; interquartile range, 38-427 days) from the index procedures and demonstrated an estimated 1-year primary stent patency rate of 83% (95% confidence interval, 57%-94%).

The use of dedicated venous stents in splanchnic vein reconstruction is feasible with a high technical success rate, favorable clinical outcomes, and promising short-term patency.