Portal vein stenting combined with ¹²⁵I strand implantation for the treatment of portal vein tumor thrombus: initial results in 12 patients

Objective: To introduce the combination therapy of portal vein stenting plus ¹²⁵I strand implantation for the treatment of portal vein tumor thrombus (PVTT) in patients with hepatocellular carcinoma (HCC). Methods: A total of 12 HCC patients associated with PVTT, who were admitted to the Department of Radiology, Shengjing Hospital, China Medical University from 2014 to the end of this study, were collected. The clinical information, imaging materials and laboratory test data were retrospectively analyzed. All patients received percutaneous transhepatic portal vein puncture with portal vein stenting and ¹²⁵I strand implantation. The feasibility, safety and complications of the operation were statistically analyzed, and the patency of the stents and the survival of the patients were discussed. Results: The interventional procedures were successfully accomplished in all the 12 patients (100%). Stent occlusion was seen in 2 patients and puncture point bleeding in one patient. Ten patients were followed up, the mean follow-up time was 8.0 months (2-15 months), the mean survival time was 8.0 months (2-15 months). The 3-, 6-, 9-, and 12-month survival rates were 77.8% (7/9), 66.7% (6/9), 62.5% (5/8) and 50.0% (3/6) respectively. During the follow-up period, 8 patients received further TACE treatment, and a total of 18 TACE procedures were performed. After the treatment, the hepatic function remained in stable condition. Conclusion: Portal vein stenting plus ¹²⁵I strand implantation can reduce the grade of tumor thrombus, maintain the patency of stent and ensure adequate portal blood supply. This therapy has expanded the range of TACE indications, and it has high value of comprehensive treatment for patients with HCC complicated by portal vein tumor thrombus. (authors)