Carnevale Francisco Cesar, de Tarso Machado Alexandre, Moreira Airton Mota, Dos Santos Aline Christine Barbosa, da Motta-Leal-Filho Joaquim Mauricio, Suzuki Lisa, Cerri Giovanni Guido, Tannuri Uenis
Interventional Radiology Unit, Institute of Radiology, Hospital das Clínicas, Sao Paulo University, Sao Paulo.
Pediatr Transplant. 2011 Aug;15(5):476-81. doi: 10.1111/j.1399-3046.2011.01481.x. Epub 2011 May 17.
This paper has the objective to evaluate retrospectively the long-term results of transhepatic treatment of PV stenoses after pediatric LT. During an eight-yr period, 15 children with PV stenoses underwent PTA with balloon dilation or stent placement in case of PTA failure after LT. Patients' body weights ranged from 9.3 to 46kg (mean, 15.5kg). PV patency was evaluated in the balloon dilation and in the stent placement groups. Technical and clinical successes were achieved in all cases with no complication. Eleven patients (11/15; 73.3%) were successfully treated by single balloon dilation. Four patients (4/15; 26.7%) needed stent placement. One patient was submitted to stent placement during the same procedure because of PTA failure. The other three developed clinical signs of portal hypertension because of PV restenoses two, eight, and twenty-eight months after the first PTA. They had to be submitted to a new procedure with stent placement. The follow-up time ranged from 3 to 8.1 yr (mean, 6.3 yr). In conclusion, transhepatic treatment of PV stenoses after pediatric LT with balloon dilation or stent placement demonstrated to be a safe and effective treatment that results in long-term patency.
本文旨在回顾性评估小儿肝移植术后经肝治疗门静脉狭窄的长期效果。在八年期间，15例门静脉狭窄患儿接受了经皮腔内血管成形术（PTA），若PTA失败则进行球囊扩张或支架置入。患者体重范围为9.3至46千克（平均15.5千克）。对球囊扩张组和支架置入组的门静脉通畅情况进行了评估。所有病例均取得技术和临床成功，无并发症发生。11例患者（11/15；73.3%）通过单次球囊扩张成功治疗。4例患者（4/15；26.7%）需要置入支架。1例患者因PTA失败在同一次手术中接受了支架置入。另外3例在首次PTA后2个月、8个月和28个月因门静脉再狭窄出现门静脉高压的临床症状，不得不再次接受支架置入手术。随访时间为3至8.1年（平均6.3年）。总之，小儿肝移植术后经肝采用球囊扩张或支架置入治疗门静脉狭窄是一种安全有效的治疗方法，可实现长期通畅。
