Portal venous thrombosis: Percutaneous therapy and outcome

Eric M. Walser, Sandra W. McNees, Octavio DeLa Pena, Wayne N. Crow, Robert A. Morgan, Roger Soloway, Thomas Broughan

Research output: Contribution to journalArticle

57 Scopus citations

Abstract

PURPOSE: To study the efficacy of percutaneous treatment for portal vein thrombosis (PVT). MATERIALS AND METHODS: Of 20 patients who were evaluated for symptomatic portal occlusion, 14 were successfully treated with use of percutaneous techniques. In patients with noncavernomatous PVT (n = 15), the initial treatment was to increase portal output by creating a transjugular intrahepatic portosystemic shunt (TIPS), which was successful in 12 cases. Methods to decrease arterial input to the portal system (hepatosplenic arterial embolization) were used as primary therapy in two patients and in an additional two patients with continued symptoms, despite a functioning TIPS. RESULTS: All TIPS survivors had patent shunts, although patients with complete PVT required more frequent revisions compared to patients with nonocclusive PVT. Hepatosplenic arterial embolization controlled symptoms in the four patients who were treated, but both patients with patent TIPS died of liver failure after embolization. Of the 14 patients treated, eight died at a mean of 6.2 months (six from hepatoma). CONCLUSION: TIPS is effective in patients with noncavernomatous PVT, although patients with complete thrombosis experience recurrent shunt occlusions and also may develop hepatoma. If TIPS fails, or if symptoms recur, hepatosplenic arterial embolization may be an option.

Original languageEnglish (US)
Pages (from-to)119-127
Number of pages9
JournalJournal of Vascular and Interventional Radiology
Volume9
Issue number1 I
DOIs
StatePublished - Jan 1 1998

Keywords

  • Liver, cirrhosis
  • Liver, interventional procedure
  • Portal vein, thrombosis
  • Shunts, portosystemic

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Portal venous thrombosis: Percutaneous therapy and outcome'. Together they form a unique fingerprint.

  • Cite this

    Walser, E. M., McNees, S. W., DeLa Pena, O., Crow, W. N., Morgan, R. A., Soloway, R., & Broughan, T. (1998). Portal venous thrombosis: Percutaneous therapy and outcome. Journal of Vascular and Interventional Radiology, 9(1 I), 119-127. https://doi.org/10.1016/S1051-0443(98)70493-2