Martins de Mattos Kessy Djonis, Marra Paolo, Carbone Francesco Saverio, Muglia Riccardo, Dulcetta Ludovico, Fagiuoli Stefano, D'Antiga Lorenzo, Sironi Sandro
School of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy.
Department of Radiology, ASST Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, Italy.
Pediatr Radiol. 2025 May;55(6):1308-1312. doi: 10.1007/s00247-025-06218-1. Epub 2025 Mar 19.
Portal hypertension resulting from non-cirrhotic extrahepatic portal vein obstruction is a cause of severe morbidity related to variceal bleeding in children. In patients not eligible for Meso-Rex bypass, rescue interventions for refractory variceal bleeding have traditionally included surgical porto-systemic shunts or transjugular intrahepatic porto-systemic shunt (TIPS), which alter the normal physiology of liver perfusion and expose children to long-term complications. Portal vein recanalization is a recently described technique which aims to restore the hepatopetal flow through the native portal system but its feasibility is often limited. We aim to present two innovative techniques of percutaneous non-anatomical portal vein recanalization for treating non-cirrhotic extrahepatic portal vein obstruction in children who failed anatomical revascularization.
非肝硬化性肝外门静脉阻塞所致的门静脉高压是儿童静脉曲张出血相关严重发病的一个原因。对于不符合门- Rex分流术条件的患者，传统上用于难治性静脉曲张出血的抢救性干预措施包括外科门体分流术或经颈静脉肝内门体分流术（TIPS），这些措施会改变肝脏灌注的正常生理状态，并使儿童面临长期并发症。门静脉再通是一种最近描述的技术，其目的是恢复通过天然门静脉系统的向肝血流，但其可行性往往有限。我们旨在介绍两种经皮非解剖性门静脉再通的创新技术，用于治疗解剖性血管重建失败的儿童非肝硬化性肝外门静脉阻塞。
