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

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Abstract

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.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Staße 3, 72076, Tuebingen, Germany

    Patrick Ghibes, Gerd Grözinger, Ilias Tsiflikas, Jürgen F. Schäfer & Christoph Artzner

  2. Department of Pediatric Gastroenterology and Hepatology, University Children’s Hospital Tuebingen, Tuebingen, Germany

    Steffen Hartleif & Ekkehard Sturm

  3. Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Gerald M. Hefferman

  4. Department of General, Visceral, and Transplant Surgery, University Hospital Tuebingen, Tuebingen, Germany

    Silvio Nadalin

  5. Department of Radiology, Diakonie-Klinikum Stuttgart, Stuttgart, Germany

    Christoph Artzner

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by P.G., G.G., and C.A. The first draft of the manuscript was written by P.G. and all authors commented on subsequent drafts of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Patrick Ghibes.

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Ethics approval

This retrospective study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Eberhard- Karls- University, Tuebingen.

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Ghibes, P., Grözinger, G., Hartleif, S. et al. Balloon angioplasty versus stent placement for the treatment of portal vein stenosis in children: a single center experience. Pediatr Radiol 53, 1885–1893 (2023). https://doi.org/10.1007/s00247-023-05674-x

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