Portal venous thrombosis

Percutaneous therapy and outcome

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

Research output: Contribution to journalArticle

57 Citations (Scopus)

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
StatePublished - 1998

Fingerprint

Venous Thrombosis
Transjugular Intrahepatic Portasystemic Shunt
Portal Vein
Thrombosis
Therapeutics
Hepatocellular Carcinoma
Portal System
Liver Failure
Survivors

Keywords

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Walser, E., 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.

Portal venous thrombosis : Percutaneous therapy and outcome. / Walser, Eric; McNees, Sandra W.; DeLa Pena, Octavio; Crow, Wayne N.; Morgan, Robert A.; Soloway, Roger; Broughan, Thomas.

In: Journal of Vascular and Interventional Radiology, Vol. 9, No. 1 I, 1998, p. 119-127.

Research output: Contribution to journalArticle

Walser, E, McNees, SW, DeLa Pena, O, Crow, WN, Morgan, RA, Soloway, R & Broughan, T 1998, 'Portal venous thrombosis: Percutaneous therapy and outcome', Journal of Vascular and Interventional Radiology, vol. 9, no. 1 I, pp. 119-127.
Walser E, McNees SW, DeLa Pena O, Crow WN, Morgan RA, Soloway R et al. Portal venous thrombosis: Percutaneous therapy and outcome. Journal of Vascular and Interventional Radiology. 1998;9(1 I):119-127.
Walser, Eric ; McNees, Sandra W. ; DeLa Pena, Octavio ; Crow, Wayne N. ; Morgan, Robert A. ; Soloway, Roger ; Broughan, Thomas. / Portal venous thrombosis : Percutaneous therapy and outcome. In: Journal of Vascular and Interventional Radiology. 1998 ; Vol. 9, No. 1 I. pp. 119-127.
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