Abstract No. 532 Percutaneous portal vein stent placement: efficacy and predictors of patency: a single-center experience in 27 patients

Abstract

To evaluate patency of portal vein (PV) stents and identify factors and predictors of stent patency. From May 2007 to March 2017, 27 patients (17 males, 10 females, mean age of 60.3, range 37-83) with main PV stenosis successfully treated with percutaneous stent were reviewed. Etiologies included: cholangiocarcinoma (n = 16), OLT stricture (n = 4), HCC (n = 3), gastric cancer (n = 2), colon cancer (n = 1) and surgical injury (n = 1). Overall survival (OS), primary patency (PP, assessed with abdominal Doppler, CT or MRI) and lab values were recorded. Mean OS was 538.5 days compared to mean PP of 533.3 days (range, for both 18-3758). Splanchnic vein involvement (p = 0.003), Child-Pugh score (p = 0.047), PV occlusions (p = 0.018), age at procedure (p = 0.038), and primary tumor staging (p = 0.045) were all found to be correlates associated with decreased PV stent patency. Specifically, patients with a primary tumor staging greater than 2 experienced decreased PV stent patency (p = 0.0183). Patients with an albumin level greater than 3 g/dL (p = 0.0017), or an alkaline phosphatase level within the normal range of 44-147 U/L (p = 0.0008) at the time of procedure experienced statistically significant longer patency. PV stent placement is safe with moderate primary patency. Factors associated with decreased patency include splanchnic vein involvement, high Child-Pugh score, PV complete occlusion, and primary tumor component (T) of TNM cancer staging. Albumin and alkaline phosphatase levels at time of procedure are predictive for portal vein stent patency.