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CardioVascular and Interventional Radiology

, Volume 37, Issue 1, pp 108–113 | Cite as

Transjugular Endovascular Recanalization of Splenic Vein in Patients with Regional Portal Hypertension Complicated by Gastrointestinal Bleeding

  • Xuefeng Luo
  • Ling Nie
  • Zhu Wang
  • Jiaywei Tsauo
  • Chengwei Tang
  • Xiao Li
Clinical Investigation

Abstract

Purpose

Regional portal hypertension (RPH) is an uncommon clinical syndrome resulting from splenic vein stenosis/occlusion, which may cause gastrointestinal (GI) bleeding from the esophagogastric varices. The present study evaluated the safety and efficacy of transjugular endovascular recanalization of splenic vein in patients with GI bleeding secondary to RPH.

Methods

From December 2008 to May 2011, 11 patients who were diagnosed with RPH complicated by GI bleeding and had undergone transjugular endovascular recanalization of splenic vein were reviewed retrospectively. Contrast-enhanced computed tomography revealed splenic vein stenosis in six cases and splenic vein occlusion in five. Etiology of RPH was chronic pancreatitis (n = 7), acute pancreatitis with pancreatic pseudocyst (n = 2), pancreatic injury (n = 1), and isolated pancreatic tuberculosis (n = 1).

Results

Technical success was achieved in 8 of 11 patients via the transjugular approach, including six patients with splenic vein stenosis and two patients with splenic vein occlusion. Two patients underwent splenic vein venoplasty only, whereas four patients underwent bare stents deployment and two covered stents. Splenic vein pressure gradient (SPG) was reduced from 21.5 ± 7.3 to 2.9 ± 1.4 mmHg after the procedure (P < 0.01). For the remaining three patients who had technical failures, splenic artery embolization and subsequent splenectomy was performed. During a median follow-up time of 17.5 (range, 3–34) months, no recurrence of GI bleeding was observed.

Conclusions

Transjugular endovascular recanalization of splenic vein is a safe and effective therapeutic option in patients with RPH complicated by GI bleeding and is not associated with an increased risk of procedure-related complications.

Keywords

Regional portal hypertension Gastrointestinal bleeding Splenic vein occlusion Transjugular endovascular recanalization 

Notes

Acknowledgments

This paper is supported by the Natural Science Fund of China (Grant Nos. 30770984 and 81171444).

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2013

Authors and Affiliations

  • Xuefeng Luo
    • 1
    • 2
  • Ling Nie
    • 1
    • 2
  • Zhu Wang
    • 1
    • 2
  • Jiaywei Tsauo
    • 1
    • 2
  • Chengwei Tang
    • 1
    • 2
  • Xiao Li
    • 1
    • 2
  1. 1.Department of GastroenterologyWest China Hospital, Sichuan UniversityChengduChina
  2. 2.Department of Interventional RadiologyWest China Hospital, Sichuan UniversityChengduChina

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