Portal vein thrombosis (PVT) is an uncommon cause for presinusoidal portal hypertension and can occur even in liver-graft recipients. Interventional radiology by percutaneous approach may represent a valid and less invasive alternative to surgical treatment. We describe three cases of PVT (2 liver-transplant patients and a cirrhotic patient candidate for liver transplantation) treated by combined mechanical and pharmacologic thrombolysis. The Arrow- Trerotola device was used along with the infusion of urokinase by way of a percutaneous-transhepatic approach. In all cases, a recanalization of the portal system was obtained and maintained during the follow-up. The best result was achieved when mechanical thrombectomy was performed before urokinase infusion. The combined locoregional treatment with mechanical thrombectomy and pharmacologic thrombolysis appears to be a promising approach for PVT because of its rapid and durable effect and its ability to reduce the dose of urokinase required to achieve recanalization.
Combined Mechanical and Pharmacologic Thrombolysis for Portal Vein Thrombosis in Liver-Graft Recipients and in Candidates for Liver Transplantation / Cristina Rossi; Andrea Zambruni; Fabio Ansaloni; Andrea Casadei; Cristina Morelli; Mauro Bernardi; and Franco Trevisani. - In: TRANSPLANTATION. - ISSN 0041-1337. - sept 27;78(2004), pp. 938-940. [10.1097/01.TP.0000137104.38602.9F]
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