Effective endovascular stenting of malignant portal vein obstruction in pancreatic cancer.

We report herein the case of a patient successfully treated by transhepatic portal venous stent placement for malignant portal vein obstruction with associated gastric and small bowel varices and repeated gastrointestinal bleeding. CT angiography and portography showed severe portal vein obstruction from recurrent pancreatic cancer 15 months following pancreaticoduodenectomy with tumor encasement and dilated collateral veins throughout the gastric and proximal small bowel wall as the suspected cause of the GI bleeding. Successful transhepatic endovascular stent placement of the splenic vein at the portal vein confluence followed by balloon dilation was performed with immediate decompression of the gastric and small bowel varices and relief of GI hemorrhage in this patient until his death four months later.

Transarterial chemoembolization in a patient with recurrent hepatocellular carcinoma and portal vein thrombosis: a case report and review of the literature.

Primary hepatocellular carcinoma (HCC) accounts for more than 5% of all cancers in the world, and causes between 250,000 and one million deaths globally each year. The incidence of portal vein thrombosis in HCC patients is around 8%. These patients are regarded as unsuitable for chemoembolization, especially if there is portal vein occlusion.

Outcomes of patients with atherosclerotic upper extremity tissue loss.

Severe ischemia of the upper extremity causing tissue necrosis occurs much less frequently than in the lower extremity. The clinical outcome of patients diagnosed with digital nonhealing ulcer or gangrene is largely unknown. A retrospective review of patients with upper extremity tissue loss was performed.