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

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  • Venous Interventions
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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.

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Abbreviations

CT:

Computed tomography

GI:

Gastrointestinal

HE:

Hepatic encephalopathy

INR:

International normalized ratio

MELD:

Model for end-stage liver disease

PVT:

Portal vein thrombosis

PH:

Portal hypertension

TIPS:

Transjugular intrahepatic portosystemic shunt

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Funding

This study was not supported by any funding.

Author information

Authors and Affiliations

  1. Interventional Radiology Department, Rede D′ Or/São Luiz, Rua Real Grandeza 108, sala 113, Botafogo, Rio de Janeiro, RJ, 22281-034, Brazil

    Raphael Braz Levigard, Henrique Salas, Henrique Serrão & Felipe Diniz

  2. Department of Internal Medicine/Hepatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Cristiane Alves Villela Nogueira, Nathalie Carvalho Leite & Maria Chiara Chindamo

  3. Department of Internal Medicine, Federal Hospital of Ipanema, Rio de Janeiro, Brazil

    Alicia Araújo de Oliveira

  4. Emergency Department, Rede D′ Or/São Luiz, Rio de Janeiro, Brazil

    Marcia Ladeira

  5. Department of Internal Medicine / Hepatology, Federal Hospital of Bonsucesso, Rio de Janeiro, Brazil

    Gustavo Pereira

Authors
  1. Raphael Braz Levigard
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  2. Henrique Salas
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  3. Henrique Serrão
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  4. Felipe Diniz
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  5. Cristiane Alves Villela Nogueira
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  6. Alicia Araújo de Oliveira
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  7. Nathalie Carvalho Leite
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  8. Marcia Ladeira
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  9. Maria Chiara Chindamo
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  10. Gustavo Pereira
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Corresponding author

Correspondence to Raphael Braz Levigard.

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The authors declare that they have no conflict of interest.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Levigard, R.B., Salas, H., Serrão, H. et al. Liver Growth and Portal Hypertension Improvement After Percutaneous Recanalization of Chronic Portal Vein Thrombosis in Non-Cirrhotic Participants. Cardiovasc Intervent Radiol 45, 582–589 (2022). https://doi.org/10.1007/s00270-022-03065-7

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  • DOI: https://doi.org/10.1007/s00270-022-03065-7

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