Balloon angioplasty versus stent placement for the treatment of portal vein stenosis in children: a single center experience

• Published in: Pediatric radiology 2023-08, Vol.53 (9), p.1885-1893
• Main Authors: Ghibes, Patrick, Grözinger, Gerd, Hartleif, Steffen, Sturm, Ekkehard, Hefferman, Gerald M., Nadalin, Silvio, Tsiflikas, Ilias, Schäfer, Jürgen F., Artzner, Christoph
• Format: Article
• Language: English
• Subjects: Angioplasty; Balloon treatment; Children; Etiology; Flow velocity; Imaging; Implants; Liver transplantation; Liver transplants; Medicine; Medicine & Public Health; Neuroradiology; Nuclear Medicine; Oncology; Original Article; Patients; Pediatrics; Placement; Platelets; Portal vein; Radiology; Spleen; Stenosis; Stents; Transplantation; Ultrasound; Veins; Velocity
• ISSN: 1432-1998; 0301-0449; 1432-1998
• DOI: 10.1007/s00247-023-05674-x

Purpose To evaluate the safety and efficacy of percutaneous interventional treatment of portal vein stenosis in children. Material and methods A retrospective analysis of all interventional treatments for portal vein stenosis in pediatric patients at a single institution from 2010 to 2021 was conducted. Platelet count, spleen size and portal vein flow velocity were assessed during the follow-up period. Primary and primary assisted patency time were determined. Results A total of ten children (median age 28.5 months, interquartile range (IQR): 2.75–52.5 months) with portal vein stenosis after Mesorex-Shunt ( n  = 4), liver transplantation ( n  = 3) and other etiologies ( n  = 3) underwent 15 interventional procedures. There were five reinterventions and one discontinued intervention. The technical success rate was 93.3% (14/15) and clinical success of treated patients was 100% (14/14). Median follow-up was 18 months (IQR: 13.5–81 months). The median primary patency time for stent placement was 70 months (IQR: 13.5–127.25 months). For balloon angioplasty, the median primary patency time was 9 months (IQR 7.25–11.5 months), while the median assisted primary patency time was 14 months (IQR: 12 to 15 months). Platelet count, spleen size and portal vein flow velocity reliably corresponded to recurrence of portal vein stenosis in asymptomatic patients during follow-up. Conclusion Interventional treatment is a safe and efficient method to treat portal vein stenosis with long patency times, regardless of etiology. Primary stent placement shows a higher primary patency time than balloon angioplasty. Implementation of stent placement as the primary interventional method may improve patency times and reduce the need for repeat reinterventions in pediatric patients.