108 - Safety, Technical and Clinical Success, and Patency of Non-Malignant Splanchnic Vein Recanalization with or Without Stent Placement

Purpose: To access the safety, technical & clinical success (TS, CS) and short/long term patency of splanchnic vein (SV) recanalization for non-malignant chronic narrowing or occlusion.

Materials and Methods: This is an IRB approved single-center retrospective study of 25 pts who had SV recanalization between (8/2019-8/25) for chronic narrowing/occlusion secondary to various non-malignant clinical conditions. Primary end-points include: safety, TS & CS, pre- and post- intervention pressure gradient, and patency at follow-up (3-48 months).



Access to SV system was obtained through transhepatic or transsplenic route. Venoplasty was performed with size 6-14F balloons. Stents were placed in 8 pts including Viabahn VBX (Gore Medical, Flagstaff, AZ), Protégé (Medtronic, Minneapolis, MN), and Express (Boston Scientific, Marlborough, MA).

Results: Overall technical success was 100% with no recurrent SV thrombosis during the follow up period (Table 1). Two incidences of minor complications were identified: stent migration – successfully repositioned and contained rupture of the portal vein-managed with stent placement.

Conclusion: These results suggest SV recanalization is a safe & effective technique with high rate of TS to restore physiological flow in chronic narrowing/occlusion with long term CS. This study is limited by the small sample size and lack of thrombosis during the follow up period. Further research is warranted to evaluate the role of post-procedural anti-coagulation and/or anti-platelet therapies to understand benefits of prolonged stent patency vs bleeding risk in patients with pre-existing variceal bleeding.