Abstract No. 379 The Efficacy and Safety of Stent Graft Placement for Portal Vein Occlusion Due to Periampullary Malignancies

To evaluate the efficacy and safety of stent graft placement for portal vein occlusion due to periampullary malignancies. This retrospective single-center study included 58 patients (36 men and 22 women; mean ± SD age, 64.2 ± 9.1 years) who underwent percutaneous transhepatic portal vein stent (n = 45) or stent graft (n = 13) placement for portal vein occlusion due to periampullary malignancies (38 cases of pancreas cancer and 20 cases of biliary cancer). from January 2018 to December 2022. These patients were referred to interventional radiology for portal hypertension-related symptoms such as refractory ascites (n = 36), variceal bleeding (n = 19), and portal hypertensive gastropathy (n = 3). Portal vein stent or stent graft was placed via the transhepatic route to relieve the portal hypertension-related symptoms. Clinical success was defined as the resolution of portal hypertension-related symptoms. Clinical success, stent patency, recurrence of symptoms, overall survival, and procedure-related adverse events were compared between stent placement and stent graft placement groups. Clinical success rate was higher in the stent graft group (12/13, 92.3%) than that in the stent group (29/45, 64.4%) (p = 0.052). After the initial relief of portal hypertension-related symptoms, a larger proportion of patients had a recurrence of symptoms in the stent group (18/29, 62.1%) than in the stent graft group (4/12, 33.3%) (p = 0.093). While the overall survival was not significantly different between the two groups (13 months in the stent graft group vs. 13 months in the stent group), longer patency was observed in the stent graft group (13 months) than in the stent group (10 months) (p =.0.018). The procedure-related adverse events were not observed in both groups. The stent graft placement for the malignant portal vein occlusion may provide more immediate symptom relief and longer patency compared to those in the stent placement without the expense of patient safety.