HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Funaki, B. Articles by Brady, L. Search for Related Content PubMed PubMed Citation Articles by Funaki, B. Articles by Brady, L.

Percutaneous Treatment of Portal Venous Stenosis in Children and Adolescents with Segmental Hepatic Transplants: Long-term Results¹

¹ From the Departments of Radiology (B.F., J.D.R., J.A.L., G.X.Z., T.F., J.L.) and Pediatrics (L.B.), the University of Chicago Hospitals, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637. Received April 16, 1999; revision requested June 10; revision received July 2; accepted July 20. Address reprint requests to B.F. (e-mail: bfunaki@midway.uchicago.edu).

View larger version (128K): [in a new window]   Figure 1a. Portal venous stenosis diagnosed at screening US in a 1-year-old boy. (a) Portal venogram obtained during contrast medium injection into the extrahepatic portal vein after percutaneous puncture shows no flow into the liver and filling of the coronary varices (long arrow). The 5-F catheter occludes a severe portal venous stenosis (short arrow), which prevents hepatopetal blood flow. PVP = portal venous pressure. (b) Fluoroscopic image demonstrates venoplasty (arrow) of the stenotic segment. (c) Repeat portal venogram obtained immediately after balloon venoplasty shows excellent flow (long arrow) beyond the dilated stenosis into the liver. There was no residual gradient across the dilated lesion. Both intrahepatic and extrahepatic portal venous pressures measured 18 mm Hg (short arrows). (d) Portal venogram obtained 1 month after venoplasty shows recurrent stenosis (short arrow), with filling of the coronary varices (long arrow). The gradient across the stenosis was 12 mm Hg. (e) Portal venogram obtained immediately after metallic stent (arrow) placement demonstrates no residual stenosis. The gradient completely resolved following stent deployment.

View larger version (112K): [in a new window]   Figure 1b. Portal venous stenosis diagnosed at screening US in a 1-year-old boy. (a) Portal venogram obtained during contrast medium injection into the extrahepatic portal vein after percutaneous puncture shows no flow into the liver and filling of the coronary varices (long arrow). The 5-F catheter occludes a severe portal venous stenosis (short arrow), which prevents hepatopetal blood flow. PVP = portal venous pressure. (b) Fluoroscopic image demonstrates venoplasty (arrow) of the stenotic segment. (c) Repeat portal venogram obtained immediately after balloon venoplasty shows excellent flow (long arrow) beyond the dilated stenosis into the liver. There was no residual gradient across the dilated lesion. Both intrahepatic and extrahepatic portal venous pressures measured 18 mm Hg (short arrows). (d) Portal venogram obtained 1 month after venoplasty shows recurrent stenosis (short arrow), with filling of the coronary varices (long arrow). The gradient across the stenosis was 12 mm Hg. (e) Portal venogram obtained immediately after metallic stent (arrow) placement demonstrates no residual stenosis. The gradient completely resolved following stent deployment.

View larger version (129K): [in a new window]   Figure 1c. Portal venous stenosis diagnosed at screening US in a 1-year-old boy. (a) Portal venogram obtained during contrast medium injection into the extrahepatic portal vein after percutaneous puncture shows no flow into the liver and filling of the coronary varices (long arrow). The 5-F catheter occludes a severe portal venous stenosis (short arrow), which prevents hepatopetal blood flow. PVP = portal venous pressure. (b) Fluoroscopic image demonstrates venoplasty (arrow) of the stenotic segment. (c) Repeat portal venogram obtained immediately after balloon venoplasty shows excellent flow (long arrow) beyond the dilated stenosis into the liver. There was no residual gradient across the dilated lesion. Both intrahepatic and extrahepatic portal venous pressures measured 18 mm Hg (short arrows). (d) Portal venogram obtained 1 month after venoplasty shows recurrent stenosis (short arrow), with filling of the coronary varices (long arrow). The gradient across the stenosis was 12 mm Hg. (e) Portal venogram obtained immediately after metallic stent (arrow) placement demonstrates no residual stenosis. The gradient completely resolved following stent deployment.

View larger version (123K): [in a new window]   Figure 1d. Portal venous stenosis diagnosed at screening US in a 1-year-old boy. (a) Portal venogram obtained during contrast medium injection into the extrahepatic portal vein after percutaneous puncture shows no flow into the liver and filling of the coronary varices (long arrow). The 5-F catheter occludes a severe portal venous stenosis (short arrow), which prevents hepatopetal blood flow. PVP = portal venous pressure. (b) Fluoroscopic image demonstrates venoplasty (arrow) of the stenotic segment. (c) Repeat portal venogram obtained immediately after balloon venoplasty shows excellent flow (long arrow) beyond the dilated stenosis into the liver. There was no residual gradient across the dilated lesion. Both intrahepatic and extrahepatic portal venous pressures measured 18 mm Hg (short arrows). (d) Portal venogram obtained 1 month after venoplasty shows recurrent stenosis (short arrow), with filling of the coronary varices (long arrow). The gradient across the stenosis was 12 mm Hg. (e) Portal venogram obtained immediately after metallic stent (arrow) placement demonstrates no residual stenosis. The gradient completely resolved following stent deployment.

View larger version (118K): [in a new window]   Figure 1e. Portal venous stenosis diagnosed at screening US in a 1-year-old boy. (a) Portal venogram obtained during contrast medium injection into the extrahepatic portal vein after percutaneous puncture shows no flow into the liver and filling of the coronary varices (long arrow). The 5-F catheter occludes a severe portal venous stenosis (short arrow), which prevents hepatopetal blood flow. PVP = portal venous pressure. (b) Fluoroscopic image demonstrates venoplasty (arrow) of the stenotic segment. (c) Repeat portal venogram obtained immediately after balloon venoplasty shows excellent flow (long arrow) beyond the dilated stenosis into the liver. There was no residual gradient across the dilated lesion. Both intrahepatic and extrahepatic portal venous pressures measured 18 mm Hg (short arrows). (d) Portal venogram obtained 1 month after venoplasty shows recurrent stenosis (short arrow), with filling of the coronary varices (long arrow). The gradient across the stenosis was 12 mm Hg. (e) Portal venogram obtained immediately after metallic stent (arrow) placement demonstrates no residual stenosis. The gradient completely resolved following stent deployment.