title: Mechanical thrombectomy of acute thrombosis in transjugular intrahepatic portosystemic shunts.
abstract: OBJECTIVE
  To evaluate the feasibility of mechanical thrombectomy with the use of the Amplatz thrombectomy device (ATD) in restoring patency to acutely thrombosed stent-shunts after transjugular intrahepatic portosystemic shunt (TIPS) placement.
  
  
  METHODS
  Mechanical thrombectomy with the ATD was performed in 10 consecutive patients with angiographically documented complete thrombosis of the stent-shunt (mean +/- SD, 6.6 +/- 3.4 cm), which occurred an average of 2.8 months (range, 0-11 months) after the TIPS procedure.
  
  
  RESULTS
  In all patients, immediate restoration of patency of the stent-shunt was achieved after thrombectomy alone (n = 1), thrombectomy plus percutaneous transluminal angioplasty (PTA; n = 4), and thrombectomy, PTA, and stenting (n = 5). The mean activation time of the ATD was 253 +/- 43 seconds. The pressure gradient for portal decompression decreased from 23 +/- 6 mmHg before to 11 +/- 3 mmHg after the procedure. The primary patency rate was 80% at 3 months and 60% at 11 months.
  
  
  CONCLUSIONS
  Mechanical thrombectomy with the ATD in acutely thrombosed TIPS is technically feasible. Mechanical thrombectomy is a potential alternative to thrombolysis.
authors.affiliation: Department of Radiology, Christian-Albrechts-University of Kiel, Germany. muehue@rad.uni-kiel.de
authors.forename: S
authors.initials: S
authors.lastname: Müller-Hülsbeck
authors.forename: M
authors.initials: M
authors.lastname: Höpfner
authors.forename: C
authors.initials: C
authors.lastname: Hilbert
authors.forename: H
authors.initials: H
authors.lastname: Krämer-Hansen
authors.forename: M
authors.initials: M
authors.lastname: Heller
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D004867:Equipment Design; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011475:Prosthesis Failure; D017131:Thrombectomy / Q000295:instrumentation*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome