Risk factors and clinical course of portal and/or splenic vein thrombosis after partial splenic embolization.
BACKGROUND
Although portal and/or splenic vein thrombosis after partial splenic embolization (PSE) is a well-known complication, few reports evaluating risk factors have been published.


OBJECTIVE
To investigate risk factors and clinical course of portal and/or splenic vein thrombosis after PSE.


METHODS
Sixteen patients with severe hypersplenism underwent PSE between March 2005 and April 2008. The correlation between portal and/or splenic vein thrombosis after PSE detected on multidetector row CT (MDCT) and various factors were retrospectively reviewed. Further, the clinical course of portal and/or splenic vein thrombosis after PSE was observed on follow-up MDCT.


RESULTS
Splenic vein thrombosis was detected in eight patients (50%) on MDCT images taken within 9 days after PSE. In one, the thrombosis also involved the portal vein. The infarct volume was identified as a significant risk factor for portal and/or splenic vein thrombosis (P=0.046). In all but one patient, splenic vein thrombosis resolved completely or improved without anticoagulation therapy. In this patient, both portal and splenic vein thrombosis developed after PSE, and anticoagulation therapy was necessary.


CONCLUSIONS
It is suggested that a large splenic infarct volume is a risk factor for portal and/or splenic vein thrombosis after PSE. Indications for treatment of thrombosis of the portal vein system after PSE may be limited to patients with portal vein thrombosis.
Matsumoto
Tomohiro
T
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto, Japan. t-matsu@koto.kpu-m.ac.jp
Yamagami
Takuji
T
Terayama
Koshi
K
Kato
Takeharu
T
Hirota
Tatsuya
T
Yoshimatsu
Rika
R
Miura
Hiroshi
H
Ito
Hirotoshi
H
Okanoue
Takeshi
T
Nishimura
Tsunehiko
T
D000328:Adult; D000368:Aged; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006971:Hypersplenism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D013162:Splenic Vein / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology
D003287:Contrast Media