title: Risks and benefits of transcatheter thrombolytic therapy in patients with splanchnic venous thrombosis.
abstract: Transcatheter local thrombolytic therapy in patients with acute, extended splanchnic venous thrombosis is controversial. Here we present our single-center experience with transcatheter thrombolytic therapy in these patients. All consecutive patients (n = 12) with acute, extended splanchnic venous thrombosis who underwent transcatheter thrombolytic therapy in our hospital, were included in this study. Thrombolytic therapy was successful for three thrombotic events and partially successful for four thrombotic events. Two patients developed minor procedure-related bleeding (17%). Six patients (50%) developed major procedure-related bleeding, with a fatal outcome in two. Transcatheter thrombolytic therapy in patients with acute, extended splanchnic vein thrombosis is found to be associated with a high rate of procedure-related bleeding. Therefore, thrombolysis should be reserved for patients in whom the venous flow cannot be restored by using conventional anticoagulant therapy or stent placement across the thrombosed vessel segment.
authors.affiliation: Department of Hematology, Erasmus University Medical Center, Room L-435, P.O. Box 2040, 3000 GD Rotterdam, The Netherlands.
authors.forename: Jasper H
authors.initials: JH
authors.lastname: Smalberg
authors.forename: Manon V M C W
authors.initials: MV
authors.lastname: Spaander
authors.forename: Kon-Siong G
authors.initials: KS
authors.lastname: Jie
authors.forename: Peter M T
authors.initials: PM
authors.lastname: Pattynama
authors.forename: Henk R
authors.initials: HR
authors.lastname: van Buuren
authors.forename: Bart
authors.initials: B
authors.lastname: van den Berg
authors.forename: Harry L A
authors.initials: HL
authors.lastname: Janssen
authors.forename: Frank W G
authors.initials: FW
authors.lastname: Leebeek
mesh_terms: D000328:Adult; D006502:Budd-Chiari Syndrome / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006470:Hemorrhage / Q000139:chemically induced / Q000401:mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011169:Portal Vein / Q000503:physiopathology; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012189:Retrospective Studies; D018570:Risk Assessment; D013152:Splanchnic Circulation; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000401:mortality; D016896:Treatment Outcome; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology
chemical_list: D005343:Fibrinolytic Agents; D005340:Fibrinogen