Liver Growth and Portal Hypertension Improvement After Percutaneous Recanalization of Chronic Portal Vein Thrombosis in Non-Cirrhotic Participants

Cardiovasc Intervent Radiol. 2022 May;45(5):582-589. doi: 10.1007/s00270-022-03065-7. Epub 2022 Feb 15.

Abstract

Purpose: To evaluate liver function improvement and volume gain after percutaneous recanalization of chronic portal vein thrombosis (PVT) in non-cirrhotic patients.

Materials and methods: In this retrospective study, five non-cirrhotic participants between 21 and 67 years old with secondary chronic PVT (4-21 years from diagnose) were submitted to percutaneous portal vein recanalization, followed by varices and shunts embolization.

Results: After a mean of 12.6 months, all portal veins remained patent and there was complete resolution of portal hypertension (PH) symptoms in all participants. There was a significant increase in liver volume of 39.8 ± 19.0% (p = 0.042), platelets count of 53120 ± 20188/μl (p = 0.042), and a significant decrease in total bilirubin levels from 1.04 ± 0.23 mg/dL to 0.51 ± 0.09 mg/dL (p = 0.043). We also found a non-significant increase in albumin levels from 3.88 ± 0.39 g/dL to 4.38 ± 0.27 g/dL (p = 0.078) and decrease in spleen diameter from 16.88 ± 4.03 cm to 14.15 ± 2.72 cm (p = 0.068).

Discussion: In this retrospective study, even with a small number of participants, we were capable of showing a median of 39.8% increase in liver volume, laboratorial liver function improvement, platelets count and resolution of PH symptoms, including gastroesophageal varices disappearance after portal vein recanalization followed by shunt embolization.

Conclusion: In this small series of cases, recanalization of chronic PVT in non-cirrhotic participants was feasible, successful and safe despite the prolonged time of occlusion. This is a new and promising approaching to an old and still challenging disease.

Keywords: Chronic portal vein thrombosis; Portal hypertension; Portal vein recanalization; Portosystemic shunt.

MeSH terms

  • Adult
  • Aged
  • Atherectomy / methods*
  • Humans
  • Hypertension, Portal* / complications
  • Hypertension, Portal* / pathology
  • Liver / growth & development
  • Liver / physiology*
  • Middle Aged
  • Portal Vein / pathology
  • Portal Vein / physiology*
  • Portasystemic Shunt, Transjugular Intrahepatic*
  • Retrospective Studies
  • Treatment Outcome
  • Venous Thrombosis / complications
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / therapy*
  • Young Adult