Journal of Gastroenterology and Digestive Diseases

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Endovascular treatment of portal vein occlusion for acute hematemesis with a modified dual transhepatic and transjugular approach.

We present a novel technique of portal venous stenting performed via a combined transhepatic and transjugular approach in a 63 year old lady admitted to our hospital with hematemesis. A CT scan showed gastro-esophageal varices and occlusion of the right main intrahepatic portal vein branch. Endoscopic treatment of the varices proved unsuccessful in controlling her haematemesis. A dual approach involving transhepatic access for portography and initial predilatation followed by transjugular access for balloon catheter angioplasty and placement of a Wallstent was employed. Portal flow was successfully restored with no complications related to the procedure. A 6-month and 1-year Ultrasound follow-up scan showed stent patency and hepatopetal flow with deflation of varices. To our knowledge this is the first reported case of a combined transhepatic and transjugular approach for the treatment of portal venous occlusion.

Author(s): Lorenzo Patrone, Irfan Ahmed, Francesco Petrocelli, Carlo Ferro