Percutaneous Direct Puncture of Retropancreatic Splenic Vein and Portal Thrombectomy in a Patient With Liver Transplantation and Simultaneous Splenectomy
Portal vein thrombosis following liver transplantation is generally managed by endovascular treatment. Although several techniques are available for portal venous access, trans-splenic access is of interest because it avoids damage to the liver graft. However, the spleen cannot be punctured to acces...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-01-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001425 |
| _version_ | 1797947157385314304 |
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| author | Takanobu Hara, MD, PhD Akihiko Soyama, MD, PhD Hideki Ishimaru, MD, PhD Hajime Matsushima, MD, PhD Hajime Imamura, MD, PhD Shuto Miyamura, MD Takashi Hamada, MD, PhD Kunihito Matsuguma, MD Masayuki Fukumoto, MD Takayuki Tanaka, MD, PhD Tomohiko Adachi, MD, PhD Masaaki Hidaka, MD, PhD Susumu Eguchi, MD, PhD |
| author_facet | Takanobu Hara, MD, PhD Akihiko Soyama, MD, PhD Hideki Ishimaru, MD, PhD Hajime Matsushima, MD, PhD Hajime Imamura, MD, PhD Shuto Miyamura, MD Takashi Hamada, MD, PhD Kunihito Matsuguma, MD Masayuki Fukumoto, MD Takayuki Tanaka, MD, PhD Tomohiko Adachi, MD, PhD Masaaki Hidaka, MD, PhD Susumu Eguchi, MD, PhD |
| author_sort | Takanobu Hara, MD, PhD |
| collection | DOAJ |
| description | Portal vein thrombosis following liver transplantation is generally managed by endovascular treatment. Although several techniques are available for portal venous access, trans-splenic access is of interest because it avoids damage to the liver graft. However, the spleen cannot be punctured to access the portal vein after splenectomy. We herein report a case of portal vein thrombosis following living donor liver transplantation with simultaneous splenectomy successfully treated by percutaneous intervention with direct puncture of the retropancreatic splenic vein. The splenic vein was punctured under computed tomography guidance in the prone position. Portal venography revealed a contrast defect due to a thrombus in the extrahepatic to intrahepatic portal vein. The portal vein was reopened after thrombectomy, and the portal vein thrombosis did not recur for 2 y. The technique and advantages of our approach are described. |
| first_indexed | 2024-04-10T21:22:22Z |
| format | Article |
| id | doaj.art-f7f95a81597643bfae794304c331ad46 |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-04-10T21:22:22Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-f7f95a81597643bfae794304c331ad462023-01-20T02:41:41ZengWolters KluwerTransplantation Direct2373-87312023-01-0191e142510.1097/TXD.0000000000001425202301000-00003Percutaneous Direct Puncture of Retropancreatic Splenic Vein and Portal Thrombectomy in a Patient With Liver Transplantation and Simultaneous SplenectomyTakanobu Hara, MD, PhD0Akihiko Soyama, MD, PhD1Hideki Ishimaru, MD, PhD2Hajime Matsushima, MD, PhD3Hajime Imamura, MD, PhD4Shuto Miyamura, MD5Takashi Hamada, MD, PhD6Kunihito Matsuguma, MD7Masayuki Fukumoto, MD8Takayuki Tanaka, MD, PhD9Tomohiko Adachi, MD, PhD10Masaaki Hidaka, MD, PhD11Susumu Eguchi, MD, PhD121 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki city, Nagasaki, Japan.1 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki city, Nagasaki, Japan.2 Department of Radiology, Nagasaki University Hospital, Nagasaki city, Nagasaki, Japan.1 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki city, Nagasaki, Japan.1 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki city, Nagasaki, Japan.2 Department of Radiology, Nagasaki University Hospital, Nagasaki city, Nagasaki, Japan.1 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki city, Nagasaki, Japan.1 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki city, Nagasaki, Japan.1 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki city, Nagasaki, Japan.1 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki city, Nagasaki, Japan.1 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki city, Nagasaki, Japan.1 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki city, Nagasaki, Japan.1 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki city, Nagasaki, Japan.Portal vein thrombosis following liver transplantation is generally managed by endovascular treatment. Although several techniques are available for portal venous access, trans-splenic access is of interest because it avoids damage to the liver graft. However, the spleen cannot be punctured to access the portal vein after splenectomy. We herein report a case of portal vein thrombosis following living donor liver transplantation with simultaneous splenectomy successfully treated by percutaneous intervention with direct puncture of the retropancreatic splenic vein. The splenic vein was punctured under computed tomography guidance in the prone position. Portal venography revealed a contrast defect due to a thrombus in the extrahepatic to intrahepatic portal vein. The portal vein was reopened after thrombectomy, and the portal vein thrombosis did not recur for 2 y. The technique and advantages of our approach are described.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001425 |
| spellingShingle | Takanobu Hara, MD, PhD Akihiko Soyama, MD, PhD Hideki Ishimaru, MD, PhD Hajime Matsushima, MD, PhD Hajime Imamura, MD, PhD Shuto Miyamura, MD Takashi Hamada, MD, PhD Kunihito Matsuguma, MD Masayuki Fukumoto, MD Takayuki Tanaka, MD, PhD Tomohiko Adachi, MD, PhD Masaaki Hidaka, MD, PhD Susumu Eguchi, MD, PhD Percutaneous Direct Puncture of Retropancreatic Splenic Vein and Portal Thrombectomy in a Patient With Liver Transplantation and Simultaneous Splenectomy Transplantation Direct |
| title | Percutaneous Direct Puncture of Retropancreatic Splenic Vein and Portal Thrombectomy in a Patient With Liver Transplantation and Simultaneous Splenectomy |
| title_full | Percutaneous Direct Puncture of Retropancreatic Splenic Vein and Portal Thrombectomy in a Patient With Liver Transplantation and Simultaneous Splenectomy |
| title_fullStr | Percutaneous Direct Puncture of Retropancreatic Splenic Vein and Portal Thrombectomy in a Patient With Liver Transplantation and Simultaneous Splenectomy |
| title_full_unstemmed | Percutaneous Direct Puncture of Retropancreatic Splenic Vein and Portal Thrombectomy in a Patient With Liver Transplantation and Simultaneous Splenectomy |
| title_short | Percutaneous Direct Puncture of Retropancreatic Splenic Vein and Portal Thrombectomy in a Patient With Liver Transplantation and Simultaneous Splenectomy |
| title_sort | percutaneous direct puncture of retropancreatic splenic vein and portal thrombectomy in a patient with liver transplantation and simultaneous splenectomy |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001425 |
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