Portalvein reconstruction with a cadaveric descending thoracic aortic homograft

Improvements in chemoradiotherapy have rendered complex pancreatic cancers involving the portal vein (PV) amenable to resection. PV reconstruction (PVR) is an essential component. Various conduits have been proposed; however, the optimal choice remains unknown. Fourteen patients underwent PVR with a...

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Bibliographic Details
Published in:Journal of vascular surgery cases and innovative techniques 2022-06, Vol.8 (2), p.294-297
Main Authors: Gaffey, Ann C., Zhang, Jason, Lee, Major K., Roses, Robert, Jackson, Benjamin M., Quatromoni, Jon G.
Format: Article
Language:English
Subjects:
Homograft
Innovative technique
Oncologic reconstruction
Portal vein reconstruction
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Summary:Improvements in chemoradiotherapy have rendered complex pancreatic cancers involving the portal vein (PV) amenable to resection. PV reconstruction (PVR) is an essential component. Various conduits have been proposed; however, the optimal choice remains unknown. Fourteen patients underwent PVR with a cadaveric descending thoracic aortic homograft from 2014 to 2020. The primary diagnosis was pancreatic cancer. The splenic vein was ligated in seven patients (50%). The 30-day and 3-, 12-, and 24-month primary patency rates were 100%, 86%, 76%, and 76%, respectively. We found a cadaveric descending thoracic aortic homograft is an excellent conduit for PVR, given the optimal size, rapidly availability, favorable risk profile, and absence of harvest site complications.
ISSN:2468-4287
2468-4287
DOI:10.1016/j.jvscit.2022.04.001