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Percutaneous treatment of symptomatic superior mesenteric vein stenosis using self- expanding nitinol stents L.P. Beyer, W.A. Wohlgemuth, W. Uller, B. Pregler, H. Goessmann, C. Niessen, M. Haimerl, C. Stroszczynski, R. Müller-Wille European Journal of Radiology Volume 84, Issue 10, Pages (October 2015) DOI: /j.ejrad Copyright © 2015 Elsevier Ireland Ltd Terms and Conditions
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Fig. 1 72-year-old female (no. 3) with colicky abdominal pain and elevated lactate after whipple procedure. The contrast enhanced CT shows mesenteric congestion, wall thickening of the ascending colon (white arrow) and intestinal loops (white arrowheads). Partial resection of the small bowel was performed before stenting of the SMV. European Journal of Radiology , DOI: ( /j.ejrad ) Copyright © 2015 Elsevier Ireland Ltd Terms and Conditions
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Fig. 2 (a–d) 56-year-old patient (no. 5) with a benign postoperative SMV stenosis. (a) Initial venogram shows the high-grade stenosis of the SMV (black arrow). (b) After catheterization of the stenosis a 10×20mm Epic stent was delivered. (c) Dilatation of the stent with an 8×20mm Mustang balloon. (d) Final venogram shows complete recanalization of the SMV. SMV=superior mesenteric vein; PV=portal vein; SV=splenic vein. European Journal of Radiology , DOI: ( /j.ejrad ) Copyright © 2015 Elsevier Ireland Ltd Terms and Conditions
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Fig. 3 (a–d) 74-year-old patient (no. 1) with a malignant occlusion of the SMV (black arrow). Direct catheterization of the SMV via the PV was technically not possible. (a) Cannulation of the SMV via a large collateral vein. (b) The occlusion was successfully catheterized retrogradely (black arrows). (c, d) Recanalization of the SMV after placement of a 14×41mm Epic stent. SMV=superior mesenteric vein; PV=portal vein. European Journal of Radiology , DOI: ( /j.ejrad ) Copyright © 2015 Elsevier Ireland Ltd Terms and Conditions
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Fig. 4 (a–c) Closure of the puncture tract using gelfoam. (a) Venogram shows correct positioning of the sheath tip (black arrow) at the transition to the intrahepatic portal vein (PV). (b) The sheath (black arrow) and a catheter filled with gelfloam slurry are retracted while applying the gelfoam to the puncture tract (white arrowheads). c) At the end of the procedure, the puncture tract is filled with gelfoam slurry. European Journal of Radiology , DOI: ( /j.ejrad ) Copyright © 2015 Elsevier Ireland Ltd Terms and Conditions
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Fig. 5 (a, b) (a) Preinterventional contrast enhanced CT shows the high-grade stenosis of the SMV (white arrow). (b) Postinterventional contrast enhanced CT shows correct placement of the stent and a complete recanalization of the SMV (white arrow). European Journal of Radiology , DOI: ( /j.ejrad ) Copyright © 2015 Elsevier Ireland Ltd Terms and Conditions
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