Title: Endovascular treatment of symptomatic hepatic venous outflow obstruction post major
liver resection
Version: 4 Date: 29 Apr 2023
Reviewer's report:
A retrospective study on an interesting topic, previously not much described in the literature.
The methods are well described and the text is easy to follow; the limitations are thoroughly
described and the figures are appropriate and easy to understand. I recommend though that the
manuscript is revised by a native english speaker.
I only have several minor issues to address:
1. In the Results section the authors describe: 8 patients with balloon PTA, 3 patients with
primary stent and 2 patients without endovascular treatment. This makes 13 patients altogether
while previously it was described that 12 patients were included in the study. The numbers
should be verified.
2. Patency rates: The primary patency rates for POBA and Stent are reported. What about the
assisted patency rates that were mentioned in the M&M section?
3. In the discussion section I find one sentences a bit misleading.
"However, a significant change in laboratory parameters in the end stage liver disease  population
is not necessarily expected": the way it follows the previous sentence one might understand that
the studied population hat end stage liver disease which is not true.
4. The paragraph starting with "In this patient population the outcomes were poor due to the
underlying malignancy": the authors only mention the outcomes in the discussion, not in the
M&M and Results section. This should be either investigated in the study, then mentioned in
the Results, or otherwise completely left out.
5. in the following paragraph: "The short-term primary patency of POBA was comparable to
primary stenting": in the Rresults quite a big difference in the patency rates was described; is
it not statistically significant?
6. "However, re-stenoses of the hepatic veins were detected in three patients (...) stent placement
with the stenotic segment located outside of the inserted stent.  " : I think this should be moved
to the results section
7. In the conclusion section: "To avoid short-term re-intervention in this patient population
primary stenting might offer advantages over sole POBA": Is this suggested by the study results?
In the results section the authors describe lower patency rates after primary stenting. This might
have different reasons and the patient number is very low but it does not suggest that it offers
advantages over POBA.
Title: Endovascular treatment of symptomatic hepatic venous outflow obstruction post major
liver resection
Version: 4 Date: 29 Apr 2023
Reviewer's report:
A retrospective study on an interesting topic, previously not much described in the literature.
The methods are well described and the text is easy to follow; the limitations are thoroughly
described and the figures are appropriate and easy to understand. I recommend though that the
manuscript is revised by a native english speaker.
I only have several minor issues to address:
1. In the Results section the authors describe: 8 patients with balloon PTA, 3 patients with
primary stent and 2 patients without endovascular treatment. This makes 13 patients altogether
while previously it was described that 12 patients were included in the study. The numbers
should be verified.
2. Patency rates: The primary patency rates for POBA and Stent are reported. What about the
assisted patency rates that were mentioned in the M&M section?
3. In the discussion section I find one sentences a bit misleading.
"However, a significant change in laboratory parameters in the end stage liver disease  population
is not necessarily expected": the way it follows the previous sentence one might understand that
the studied population hat end stage liver disease which is not true.
4. The paragraph starting with "In this patient population the outcomes were poor due to the
underlying malignancy": the authors only mention the outcomes in the discussion, not in the
M&M and Results section. This should be either investigated in the study, then mentioned in
the Results, or otherwise completely left out.
5. in the following paragraph: "The short-term primary patency of POBA was comparable to
primary stenting": in the Rresults quite a big difference in the patency rates was described; is
it not statistically significant?
6. "However, re-stenoses of the hepatic veins were detected in three patients (...) stent placement
with the stenotic segment located outside of the inserted stent.  " : I think this should be moved
to the results section
7. In the conclusion section: "To avoid short-term re-intervention in this patient population
primary stenting might offer advantages over sole POBA": Is this suggested by the study results?
In the results section the authors describe lower patency rates after primary stenting. This might
have different reasons and the patient number is very low but it does not suggest that it offers
advantages over POBA.
Please review this paper.
user
Title: Endovascular treatment of symptomatic hepatic venous outflow obstruction post major
liver resection
Version: 4 Date: 29 Apr 2023
Reviewer's report:
A retrospective study on an interesting topic, previously not much described in the literature.
The methods are well described and the text is easy to follow; the limitations are thoroughly
described and the figures are appropriate and easy to understand. I recommend though that the
manuscript is revised by a native english speaker.
I only have several minor issues to address:
1. In the Results section the authors describe: 8 patients with balloon PTA, 3 patients with
primary stent and 2 patients without endovascular treatment. This makes 13 patients altogether
while previously it was described that 12 patients were included in the study. The numbers
should be verified.
2. Patency rates: The primary patency rates for POBA and Stent are reported. What about the
assisted patency rates that were mentioned in the M&M section?
3. In the discussion section I find one sentences a bit misleading.
"However, a significant change in laboratory parameters in the end stage liver disease  population
is not necessarily expected": the way it follows the previous sentence one might understand that
the studied population hat end stage liver disease which is not true.
4. The paragraph starting with "In this patient population the outcomes were poor due to the
underlying malignancy": the authors only mention the outcomes in the discussion, not in the
M&M and Results section. This should be either investigated in the study, then mentioned in
the Results, or otherwise completely left out.
5. in the following paragraph: "The short-term primary patency of POBA was comparable to
primary stenting": in the Rresults quite a big difference in the patency rates was described; is
it not statistically significant?
6. "However, re-stenoses of the hepatic veins were detected in three patients (...) stent placement
with the stenotic segment located outside of the inserted stent.  " : I think this should be moved
to the results section
7. In the conclusion section: "To avoid short-term re-intervention in this patient population
primary stenting might offer advantages over sole POBA": Is this suggested by the study results?
In the results section the authors describe lower patency rates after primary stenting. This might
have different reasons and the patient number is very low but it does not suggest that it offers
advantages over POBA.
assistant