Portal Venous Stenting in Locally Advanced Pancreatic Cancer to Decrease Risk of Thrombosis Before Irreversible Electroporation: A Case Report and Review of the Literature
Background: For patients with locally advanced pancreatic cancer, irreversible electroporation (IRE) is a fairly novel treatment tool that has shown promise in improving survival. However, many patients being considered for IRE have tumors adjacent to and/or encasing portal vasculature, increasing r...
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Mary Ann Liebert
2017-03-01
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doaj-eba8a9dce3a24e10bd544505a0661c4b2020-11-24T21:10:47ZengMary Ann LiebertJournal of Pancreatic Cancer 2475-32462017-03-0131151810.1089/PANCAN.2016.0022Portal Venous Stenting in Locally Advanced Pancreatic Cancer to Decrease Risk of Thrombosis Before Irreversible Electroporation: A Case Report and Review of the LiteratureJustin F. Monroe0Thor Johnson1Barish H. Edil2Department of Radiology, University of Colorado at Denver—Anschutz Medical CampusDepartment of Radiology, University of Colorado at Denver—Anschutz Medical CampusDepartment of Surgery, University of Colorado at Denver—Anschutz Medical CampusBackground: For patients with locally advanced pancreatic cancer, irreversible electroporation (IRE) is a fairly novel treatment tool that has shown promise in improving survival. However, many patients being considered for IRE have tumors adjacent to and/or encasing portal vasculature, increasing risk of postoperative portal vein thrombosis and associated complications. This report describes a successful new approach of portal venous stenting preoperatively to decrease this risk. Case Presentation: A 64-year-old female with locally advanced pancreatic cancer, initially deemed too high risk for IRE therapy because of portal vein–superior mesenteric vein confluence encasement and compression, was offered and underwent venous stenting to decrease the chance of postoperative thrombosis and related complications. Stenting improved portal venous flow, decreased collateralization, and allowed for successful IRE. At 61 days post-IRE, there was no significant tumor growth and the stent remained patent. Conclusion: Preoperative portomesenteric stenting could expand the population eligible for IRE therapy, allowing for this treatment in patients without other options. To the authors' knowledge, this is the first reported case of portal venous stenting for this purpose.https://www.liebertpub.com/doi/full/10.1089/PANCAN.2016.0022irreversible electroporationlocally advanced pancreatic cancerportal veinvenous stentingportal vein thrombosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Justin F. Monroe Thor Johnson Barish H. Edil |
spellingShingle |
Justin F. Monroe Thor Johnson Barish H. Edil Portal Venous Stenting in Locally Advanced Pancreatic Cancer to Decrease Risk of Thrombosis Before Irreversible Electroporation: A Case Report and Review of the Literature Journal of Pancreatic Cancer irreversible electroporation locally advanced pancreatic cancer portal vein venous stenting portal vein thrombosis |
author_facet |
Justin F. Monroe Thor Johnson Barish H. Edil |
author_sort |
Justin F. Monroe |
title |
Portal Venous Stenting in Locally Advanced Pancreatic Cancer to Decrease Risk of Thrombosis Before Irreversible Electroporation: A Case Report and Review of the Literature |
title_short |
Portal Venous Stenting in Locally Advanced Pancreatic Cancer to Decrease Risk of Thrombosis Before Irreversible Electroporation: A Case Report and Review of the Literature |
title_full |
Portal Venous Stenting in Locally Advanced Pancreatic Cancer to Decrease Risk of Thrombosis Before Irreversible Electroporation: A Case Report and Review of the Literature |
title_fullStr |
Portal Venous Stenting in Locally Advanced Pancreatic Cancer to Decrease Risk of Thrombosis Before Irreversible Electroporation: A Case Report and Review of the Literature |
title_full_unstemmed |
Portal Venous Stenting in Locally Advanced Pancreatic Cancer to Decrease Risk of Thrombosis Before Irreversible Electroporation: A Case Report and Review of the Literature |
title_sort |
portal venous stenting in locally advanced pancreatic cancer to decrease risk of thrombosis before irreversible electroporation: a case report and review of the literature |
publisher |
Mary Ann Liebert |
series |
Journal of Pancreatic Cancer |
issn |
2475-3246 |
publishDate |
2017-03-01 |
description |
Background: For patients with locally advanced pancreatic cancer, irreversible electroporation (IRE) is a fairly novel treatment tool that has shown promise in improving survival. However, many patients being considered for IRE have tumors adjacent to and/or encasing portal vasculature, increasing risk of postoperative portal vein thrombosis and associated complications. This report describes a successful new approach of portal venous stenting preoperatively to decrease this risk.
Case Presentation: A 64-year-old female with locally advanced pancreatic cancer, initially deemed too high risk for IRE therapy because of portal vein–superior mesenteric vein confluence encasement and compression, was offered and underwent venous stenting to decrease the chance of postoperative thrombosis and related complications. Stenting improved portal venous flow, decreased collateralization, and allowed for successful IRE. At 61 days post-IRE, there was no significant tumor growth and the stent remained patent.
Conclusion: Preoperative portomesenteric stenting could expand the population eligible for IRE therapy, allowing for this treatment in patients without other options. To the authors' knowledge, this is the first reported case of portal venous stenting for this purpose. |
topic |
irreversible electroporation locally advanced pancreatic cancer portal vein venous stenting portal vein thrombosis |
url |
https://www.liebertpub.com/doi/full/10.1089/PANCAN.2016.0022 |
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