Interventional radiologic treatment for idiopathic portal hypertension

Purpose: To evaluate the usefulness of interventional radiological treatmen t for idiopathic portal hypertension. Methods: Between 1995 and 1998, we performed an interventional radiological treatment in five patients with idiopathic portal hypertension, four of wh om had refused surgery and one of whom had undergone surgery. Three patient s with gastroesophageal varices (GEV) were treated by partial splenic embol ization (PSE), one patient with esophageal varices (EV) and massive ascites by transjugular intrahepatic portosytemic shunt (TIPS) and PSE, and one pa tient with GEV by percutaneous transhepatic obliteration (PTO). Midterm res ults were analyzed in terms of the effect on esophageal and/or gastric vari ces. Results: In one woman with severe GEV who underwent three sessions of PSE, there was endoscopic confirmation that the GEV had disappeared. In one man his EV shrunk markedly after two sessions of PSE. In two patients slight re duction of the EV was obtained with one application of PSE combined with en doscopic variceal ligation therapy. PTO for GV in one patient resulted in g ood control of the varices. All patients have survived for 16-42 months sin ce the first interventional treatment, and varices are well controlled. Conclusion: Interventional radiological treatment is effective for patients with idiopathic portal hypertension, whether or not they have undergone su rgery.