Obstructed surgical porto-systemic shunts in the early postoperative period: interventional therapy by angioplasty (PTA) and stent placement.

Purpose: Recurrent variceal bleeding in patients treated with surgical port o-systemic shunting is most often due to shunt stenoses or occlusion. Radio logical interventional procedures are a possible method of therapy and our experience herein is described in this report. Patients and Methods: From 1 997 to 1999 54 patients with recurrent variceal bleeding were treated with a surgical porto-systemic shunt procedure. Of these early shunt occlusion o ccurred in 5 patients, which was treated with percutaneous transcatheter te chniques. Results: In only one patient was PTA alone sufficient to reestabl ish shunt patency, in four patient stent placement was necessary in additio n. In the follow-up period 1 patient died 26 month after intervention with (autopsy-proven) patent shunt, in one patient shunt reocclusion occurred af ter 11 months and in 3 patients the shunt is still patent. Conclusions: PTA , if necessary in combination with stent placement, is an attractive altern ative method of therapy in case of an early surgical porto-systemic shunt o cclusion.