Table 7.

Portal vein stenosis highlights

Summary of the clinical characteristics about PVS
The true incidence of PVS is not really known, but is thought to be < 3%
The major complication of PVS is the evolution to PVT if not treated
The majority of patients with PVS are asymptomatic and the diagnosis of stenosis is an incidental finding detected on routine DUS screening
Risk factors of PVS are almost exclusively represented by technical errors, particularly if a tapered anastomosis is required in the case of a vessel size mismatch between donor and recipient
Pre-OLT radiotherapy is another major predisposing factor of PVS
DUS with the finding of a stenosis ratio > 50% or a portal velocity ratio > 3:1 defines PVS. Contrast-enhanced CT and portography are used to confirm the diagnosis
If PVS is asymptomatic, no therapeutic intervention with close surveillance is possible, but anticoagulation therapy is recommended
In patients with clinical manifestations, percutaneous radiological intervention is the method of choice by transhepatic or transjugular access to perform angioplasty with our without stent placement; this prevents recurrence with a high rate of success and low rate of complications

PVT: Portal vein thombosis; PVS: Portal vein stenosis; DUS: Doppler ultrasound; OLT: Orthotopic liver transplantation; CT: Computed tomography.