• Tan Tan, Yudong Xiao, Shunke Zhou, Cong Ma, and Zishu Zhang.
• Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China.
• Medicine (Baltimore). 2017 Nov 1; 96 (46): e8660.

RationaleCurrently, the treatment of hepatocellular carcinoma (HCC) associated with portal vein tumor thrombosis (PVTT) is a challenge. Percutaneous puncture endovascular placement of iodine-125 (I) seeds strand and stent is reported to treat HCC with tumor thrombus effectively. However, it is proved to be only suitable for the main portal vein (MPV) thrombus.Patient ConcernsA 42-year-old male patient was referred to our institution after experiencing right upper abdominal distention without abdominal pain, nausea, or vomiting for 2 weeks. The patient had a history of hepatitis B virus infection over a 20 year period.DiagnosisAfter a full evaluation, the patient was diagnosed with primary HCC with a tumor thrombus in both main and branch portal veins.InterventionsWe used a Y-configuration stent combined with I seeds strand to treat the tumor thrombus in both main and branch portal veins.OutcomesThe patient's liver function and the stent patency period were improved. More importantly, the patient had an acceptable survival time.LessonsA Y-configuration stent makes it possible to treat tumor thrombosis in portal vein branches (PVBs). However, the long-term curative effects of Y-configuration stents need to be verified.

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