Portal vein stenting to treat portal vein tumor thrombus in hepatocellular carcinoma.

Tumor thrombus in the portal vein is refractory to therapy and a serious negative prognostic factor in hepatocellular carcinoma. We describe herein the case of a patient in whom an expandable metallic stent was successfully employed to treat portal vein tumor thrombus by restoring blood flow. An expandable metallic stent was implanted in a patient with severe main portal vein stenosis caused by tumor thrombus protruding from the left portal vein branch. Immediately after stent placement, the stenotic lesion was effectively dilated, the portal blood flow restored, and portal hypertension relieved. Angiography, computed tomography, and doppler ultrasonography done 2 months after the stent placement revealed continued patency of the portal vein. Thus, intraportal placement of an expandable metallic stent appears to be an effective treatment for major portal vein tumor