Portal vein thrombosis after double installation of transjugular intrahepatic portosystemic stent (clinical observation)

Abstract

Relevance. Liver transplantation involves reconstruction of several vascular structures. Portal reconstruction presents many difficulties due to the frequent intraoperative detection of thrombosis. Portal vein thrombosis is a condition caused by stagnation of blood flow, vascular injury, or hypercoagulability, leading to partial or complete occlusion of the portal vein. The prevalence of thrombosis ranges from 2.1 to 23.3% among liver transplant candidates without hepatocellular cancer. According to autopsy data, the incidence of thrombosis in liver cirrhosis is 6– 64%.Purpose: to analyze a case of portal vein thrombosis in a patient with two preliminary attempts to install transjugular intrahepatic portosystemic stents and their thrombosis.Materials and methods: a clinical case of thrombosis of the stent and portal vein in a 53-year-old patient with decompensated liver cirrhosis as a result of viral hepatitis C with portal hypertension. The peculiarity of this case is that after double transjugular intrahepatic portosystemic stenting, thrombosis of the venous vein was detected only intraoperatively. A liver transplant was performed; the functionality of the graft was not impaired.Conclusion. This case illustrates the need for future research on the topic of portal vein thrombosis and techniques for identifying it preoperatively.