Endovascular treatment for shunt stenosis or occlusion after restricted portosystemic shunt：An analysis of 24 cases        WANG Zhi-wei，MA Xiu-xian，WANG Jia-xiang, et al. Department of Vascular and Endovascular Surgery，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052, China
Corresponding author：WANG Jia-xiang, E-mail：wangzhiwei126@126.com
Abstract    Objective    To explore the cause of artificial vessel stenosis or occlusion after restricted portosystemic shunt (mesocaval shunt was short for superior mesenteric vein-inferior vena cava shunt; spleen shunt was short for splenic vein-inferior vena cava shunt), and analysis the feasibility and efficacy of percutaneous endovascular therapy. Methods The clinical data of 24 cases of artificial vessel stenosis or occlusion after restricted portosystemic shunt for portal hypertension from March 2009 to March 2012 in Department of Endovascular Surgery, the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively (19 cases of mesocaval shunt, 15 cases of spleen shunt). Results    In the 24 cases of artificial vessels stenosis or occlusion treated by restricted portosystemic shunt for portal hypertension, 7 cases who got acute thrombosis within a week after the surgery were treated by catheter directed thrombolysis; 9 cases who got shunts stenosis for anastomotic stenosis of artificial vessel-superior mesenteric vein from 1 to 8 years after surgery were cured by balloon dilatation or stent angioplasty. The shunts artificial vascular occlusion occurred in 8 cases from 1 to 4 years after surgery, 6 of whom succeed to be patent by balloon dilatation or stent angioplasty, and 2 cases were failed for the guide wire can’t go through the anastomotic site of artificial vessel-superior mesenteric vein. And 13 cases were associated with embolism of esophagogastric varices for postoperative standard anticoagulation. Conclusion    Endovascular therapy by percutaneous puncture through "femoral vein-inferior vena cava-artificial vessel-portal vein” (including catheter directed thrombolysis, balloon dilatation, stent placement ,etc) are little trauma, highly successful and have a remarkable effect in the treatment of shunt stenosis or occlusion after restricted portosystemic shunt in portal hypertension.