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 Pub Date : 2017-03-01 eCollection Date: 2017-01-01 DOI:10.1089/pancan.2016.0022
Justin F Monroe, Thor Johnson, Barish H Edil
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引用次数: 1

Abstract

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.

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门静脉支架置入术治疗局部晚期胰腺癌,在不可逆电穿孔前降低血栓风险:1例报告及文献回顾。
背景:对于局部晚期胰腺癌患者,不可逆电穿孔(IRE)是一种相当新颖的治疗工具,有望提高生存率。然而,许多考虑进行IRE的患者肿瘤邻近和/或包裹门静脉血管,增加了术后门静脉血栓形成和相关并发症的风险。本报告描述了一种成功的门静脉支架手术的新方法,以减少这种风险。病例介绍:一名64岁的局部晚期胰腺癌女性患者,由于门静脉-肠系膜上静脉汇合处的堵塞和压迫,最初被认为是IRE治疗的高风险,因此接受了静脉支架植入术以减少术后血栓形成和相关并发症的机会。支架置入术改善门静脉血流,减少侧支,使IRE成功。在ire后61天,没有明显的肿瘤生长,支架保持通畅。结论:术前肠系膜支架植入术可以扩大IRE治疗的适用人群,允许在没有其他选择的患者中进行这种治疗。据作者所知,这是第一例门静脉支架植入术的报道。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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