title: Catheter-directed continuous thrombolysis following aspiration thrombectomy via the ileocolic route for acute portal venous thrombosis: report of two cases.
abstract: Although acute portal venous thrombosis (PVT) is a potentially life-threatening complication that occurs after hepatobiliary surgery with portal vein (PV) reconstruction or splenectomy, no effective or universal treatments have yet been established. Transjugular or transhepatic catheter-directed thrombolysis has recently been reported to be effective for treating acute PVT. However, the efficiency of this treatment for complete PV occlusion might be limited because a poor portal venous flow prevents thrombolytic agents from reaching and dissolving thrombi. Moreover, the use of the transjugular or transhepatic route might not be suitable in patients who have undergone major hepatectomy or in those with ascites due to an increased risk of residual liver injury or intra-abdominal bleeding following puncture to the residual liver. We herein describe the cases of two patients with almost total PV occlusion caused by massive thrombi that formed after hepatobiliary surgery, who were successfully treated with catheter-directed continuous thrombolysis following aspiration thrombectomy via the ileocolic route. This treatment should be considered beneficial for treating selected patients such as the two patients described herein.
authors.affiliation: Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori 1-757, Niigata, 951-8510, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Miura
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Sato
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakatsuka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Oya
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hara
authors.forename: Hidenaka
authors.initials: H
authors.lastname: Kokai
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama
mesh_terms: D000208:Acute Disease; D000368:Aged; D005260:Female; D006801:Humans; D061185:Mechanical Thrombolysis / Q000379:methods*; D008875:Middle Aged; D011169:Portal Vein; D011183:Postoperative Complications; D013396:Suction / Q000379:methods*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000628:therapy*