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Endovascular treatment for nonacute symptomatic portal venous thrombosis through intrahepatic portosystemic shunt approach.
MedLine Citation:
PMID:  21106386     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE: To study the safety and efficacy of nonacute symptomatic portal vein thrombosis (PVT) treated by mechanical thrombectomy combined with pharmacologic thrombolysis through an intrahepatic portosystemic shunt (IPS) approach.
MATERIALS AND METHODS: Thirteen patients with nonacute symptomatic PVT were included in this study: five women and eight men, with a mean age of 48.9 y. Indications for therapy were variceal bleeding (n = 7) and abdominal pain, distension, or intermittent melena (n = 6). Through an IPS approach, balloon angioplasty, sheath-directed thrombus aspiration, and continuous infusion of urokinase were performed. Clinical follow-up was performed in all patients.
RESULTS: An IPS was successfully created in all patients. After therapy, recanalization of all thrombosed main PVs was achieved. A majority of thrombus was removed and lysed. The overall rate of clinical improvement was 92.3%. One patient died of intraperitoneal bleeding the second day after the procedure, and another two patients experienced minor complications after therapy and recovered completely after conservative medical management. During a mean of 14.9 months of follow-up, two patients experienced recurrent variceal bleeding as a result of shunt dysfunction. Hemostasis was achieved after shunt revision. No other complications occurred.
CONCLUSIONS: Through an IPS approach, mechanical thrombectomy combined with pharmacologic thrombolysis was possible as a therapeutic option for patients with nonacute symptomatic PVT.
Authors:
Jianjun Luo; Zhiping Yan; Jianhua Wang; Qingxin Liu; Xudong Qu
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Publication Detail:
Type:  Journal Article     Date:  2010-11-24
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  22     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  61-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China. michealluo@163.com
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