Abstract
Management of portal hypertension (PHTN) in pediatric patients presents challenges
due to the smaller anatomy and a lack of standardized protocols. While evidence for
endovascular management of ectopic varices, maintenance of surgical shunts, portal
venous recanalization, and percutaneous portosystemic shunt creation in children grows,
adaptation requires specialized techniques and equipment. This review explores the
etiologies of pediatric PHTN, including Budd–Chiari syndrome, congenital anomalies,
extrahepatic portal vein obstruction, and transplant vascular occlusions, and examines
radiologic interventions to address these conditions. Management strategies are divided
into relieving the primary cause of PHTN at the level of portal obstruction and managing
the secondary effects of PHTN. For each category, the discussion focuses on device
selection, postprocedural care, imaging surveillance, and management of pediatric
scenarios.
Keywords
portal hypertension - portal vein - pediatric - interventional radiology - shunt -
transplantation
