Extrahepatic portal venous stenosis: Treatment with percutaneous transhepatic stent placement

PREHEPATIC portal venous hypertension can be caused by a number of processes including portal venous thrombosis, arteriovenous fistula, and neoplastic obstruction. Treatment options have included direct surgical repair, decompression by means of portacaval or mesocaval shunting, and endoscopic sclerotherapy. The use of endovascular stents has recently permitted percutaneous treatment of this condition. We report the successful treatment of two patients with extrahepatic portal venous stenosis. Both patients underwent placement of vascular stents to alleviate persistent bleeding caused by a neoplastic stricture in one patient and postoperative narrowing in the other. The first stent remained effectively patent for 5 months (until the patient's death), and the second stent was patent at 19 months.