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Fig. 1 | CVIR Endovascular

Fig. 1

From: Long-term efficacy and risk factors for stent occlusion in portal vein stent placement: a multi-institutional retrospective study

Fig. 1

A patient with residual stenosis (in-stent) which resulted in stent occlusion. A man in his 70 s presented with hematochezia eight months after pancreaticoduodenectomy for pancreas cancer. Portal vein (PV) occlusion due to postoperative pancreatic fistula was confirmed on contrast-enhanced computed tomography (CT). In addition, development of hepatopetal collateral veins were observed around the choledochojejunostomy. Portography showed PV occlusion with hepatopetal collateral vein development. Two stents (SMART Control; Cordis, Hialeah, FL, USA) were placed through the occlusion and post-stent balloon dilatation was performed up to the nominal pressure. A Although residual in-stent stenosis (arrow) remained, PV flow improved at the end of the procedure. Contrast-enhanced CT was performed two days after stent placement and intra-stent thrombus was suspected. His hematochezia still persisted and anemia progressed, so additional treatment was scheduled. B Portography four days after the first stent placement shows recurrent PV occlusion. C After additional stent placement (SMART Control), hepatopetal PV flow had improved and flow through the collateral veins disappeared. The stent patency has been maintained for six years after the placement

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