Percutaneous portal venoplasty and stenting for anastomotic stenosis after liver transplantation

Figure 1 Procedure of percutaneous transhepatic portal venoplasty and stenting. A: Percutaneous transhepatic portography revealed a severe anastomotic stenosis and gastroesophageal varices; B: Portal venoplasty was performed with an undersized balloon and the balloon was slowly inflated; C: Postvenoplasty portography showed a residual stenosis, but gastroesophageal varices became almost invisible; D: Poststenting portography visualized portal venous patency and inflow had recovered completely.

Figure 2 A 28-year-old man with a pre-existing meso-caval shunt. A: Initial portography revealed an almost occlusive anastomosis; B: Portography detected a pre-existing meso-caval shunt due to visualization of the inferior vena cava; C: After stenting, the contrast agents flowed mainly into the inferior vena cava via the shunt and little flowed into the portal vein; D: A covered stent was deployed into the superior mesenteric vein to occlude the shunt. Portal hepatopetal flow was restored and the inferior vena cava became invisible.