Outcomes of Percutaneous Interventions for Managing Stenosis after Meso-Rex Bypass for Extrahepatic Portal Vein Obstruction

Meso-Rex bypass for extrahepatic portal vein obstruction in children

“…This is more consistent with the figures presented here and gives a realistic picture of the outcome of MRB. A paper from the same institution reported on 15 of 86 patients with late stenosis or thrombosis of the MRB, of whom nine were treated successfully with endovascular procedures. These late stenoses/thromboses would have been picked up earlier in the present study, as oesophagogastroduodenoscopy was performed routinely at 6 months' follow‐up.…”

“…A paper from the same institution reported on 15 of 86 patients with late stenosis or thrombosis of the MRB, of whom nine were treated successfully with endovascular procedures. These late stenoses/thromboses would have been picked up earlier in the present study, as oesophagogastroduodenoscopy was performed routinely at 6 months' follow‐up. Oesophagogastroduodenoscopy seems more reliable than Doppler ultrasonography, platelet count or spleen size for the detection of recurrence of clinical portal hypertension.…”

A bidirectional approach for portal vein stent placement in a child with complete portal vein occlusion after living donor liver transplantation

“…The reported overall survival rate of pediatric patients with post‐transplant PVT is 96%, and the long‐term patency rate is 100% when the self‐internal jugular vein is used for the bypass . However, shunt stenosis and thrombosis have still been described and are more likely to occur at the hepatic end due to the narrow caliber of the intrahepatic branch of the PV and the angulation necessary for the shunt to reach the more posterior position of this intrahepatic PV .…”

Surgical Mesoportal Bypass and Portosystemic Shunt Interventions

“…In patients with suspicion for graft stenosis, a CT venography with orthogonal reformatting along the graft allows better visualization of focal narrowing with some authors considering less than 3 mm significant. 43 At the authors' institution, sequela of portal hypertension, or abnormal Doppler US typically prompt catheter venography without intervening CT.…”

“…Safety and efficacy of meso-Rex bypass have been well-established with long-term patency approaching 90%. 43 While there is a high initial technical success rate, mesoportal bypasses and portosystemic shunts suffer from a relatively high rate of stenosis or occlusion, with an estimated frequency between 2 and 40%. 8,29,45 Moreover, recurrent stenosis develops in approximately 20% of patients.…”