title: Interventional treatment of mesenteric venous occlusion.
abstract: BACKGROUND
  Mesenteric venous thrombus may be an incidental finding during imaging studies and asymptomatic patients are treated conservatively or with anticoagulant therapy only. Patients with symptomatic acute thrombosis causing bowel ischemia require urgent treatment, which frequently includes extensive surgery. Interventional treatment may be an alternative.
  
  
  OBJECTIVE
  To present results of interventional treatment in patients with symptomatic occlusion of the mesenteric veins.
  
  
  METHODS
  Eight patients, four men and four women aged 24-74 years (mean 53 years) were treated due to symptomatic portomesenteric venous occlusion of thrombotic origin. Transhepatic (n=5), trans-splenic (n=2), and transjugular (n=4) accesses were used. Patients were treated with mechanical thrombus fragmentation (n=4), pharmacological thrombolysis (n=3) and stent placement (n=8). Additional transjugular intrahepatic portosystemic shunt (TIPS) was created to facilitate the outflow from the treated veins (n=4).
  
  
  RESULTS
  The majority of the patients required combination of different treatment methods. Resolution of symptoms with initial clinical success was achieved in seven of the eight patients, and one patient died the day after the procedure due to sepsis. Two other patients had procedure-related complications; one of them required embolization. Two patients had documented long-term clinical success with patent stents and no symptoms at one year following intervention.
  
  
  CONCLUSIONS
  Endovascular treatment of portomesenteric occlusion in patients with acute symptomatology showed good short-term clinical success rate.
authors.affiliation: Department of Radiology, Covenant Medical Center, Waterloo, IA, U.S.A.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Wichman
authors.affiliation: Department of Interventional Radiology, Skane University Hospital, Lund, Sweden.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Cwikiel
authors.affiliation: Department of Interventional Radiology, Skane University Hospital and Lund University Hospital, Lund, Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Keussen
keywords: Mesenteric Vascular Occlusion; Mesenteric Veins; Stents
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