Balloon angioplasty versus stent placement for the treatment of portal vein stenosis in children: a single center experience.

Abstract

To evaluate the safety and efficacy of percutaneous interventional treatment of portal vein stenosis in children. A retrospective analysis of all interventional treatments for portal vein stenosis in pediatric patients at a single institution from 2010 to 2021 was conducted. Platelet count, spleen size and portal vein flow velocity were assessed during the follow-up period. Primary and primary assisted patency time were determined. A total of ten children (median age 28.5months, interquartile range (IQR): 2.75-52.5months) with portal vein stenosis after Mesorex-Shunt (n = 4), liver transplantation (n = 3) and other etiologies (n = 3) underwent 15 interventional procedures. There were five reinterventions and one discontinued intervention. The technical success rate was 93.3% (14/15) and clinical success of treated patients was 100% (14/14). Median follow-up was 18months (IQR: 13.5-81months). The median primary patency time for stent placement was 70months (IQR: 13.5-127.25months). For balloon angioplasty, the median primary patency time was 9months (IQR 7.25-11.5months), while the median assisted primary patency time was 14months (IQR: 12 to 15months). Platelet count, spleen size and portal vein flow velocity reliably corresponded to recurrence of portal vein stenosis in asymptomatic patients during follow-up. Interventional treatment is a safe and efficient method to treat portal vein stenosis with long patency times, regardless of etiology. Primary stent placement shows a higher primary patency time than balloon angioplasty. Implementation of stent placement as the primary interventional method may improve patency times and reduce the need for repeat reinterventions in pediatric patients.