Thrombolytic therapy in patients with portal vein thrombosis

Portal vein thrombosis in the district general hospital: management and clinical outcomes

“…This is likely the consequence of physician concerns regarding safety and compliance with anticoagulation. None of our patients received intravascular thrombolysis, although retrospective studies have shown thrombolysis to be effective in acute PVT and in patients with failed anticoagulation therapy [20,21]. None of our patients underwent transjugular intrahepatic portosystemic shunting, even though it has been shown to ameliorate symptoms and reduce rebleeding in selected patients with symptomatic complete PVT with or without cavernous transformation [22].…”

Thrombolytic therapy is effective in paroxysmal nocturnal hemoglobinuria: a series of nine patients and a review of the literature

“…The use of catheter-directed therapy has also been emphasized with respect to Budd-Chiari syndrome, and it has been claimed that systemic thrombolytic therapy is not effective for this condition, based on two out of three patients who did not respond. 28 However, there is no anatomic reason why hepatic vein thrombosis should not be amenable to systemic thrombolysis, since this therapy has succeeded with portal vein thrombosis, 27 which may be difficult to access by a catheter approach.…”

“…These agents also have a role in patients who have had arterial cerebral vascular accidents, 21,22 in patients who are in hemodynamic shock from pulmonary emboli, and in patients with venous thrombosis at other sites. [23][24][25][26][27][28]29,30 As for PNH, there have been a number of papers in the literature, [10][11][12][13][14][15][17][18][19]31,32 most of them on isolated cases. Here we report our experience with thrombolytic therapy in a highly selected group of nine patients with PNH, all of whom had severe thrombotic complications, which were regarded as potentially fatal if not treated, or which were progressing despite anticoagulation: in this respect, tissue plasminogen activator (tPA) can be regarded as a second-line treatment for patients with PNH complicated by venous thrombosis.…”

Acute extensive portal and mesenteric venous thrombosis after splenectomy: Treated by interventional thrombolysis with transjugular approach

“…Combining thrombolytic infusion with anticoagulation would appear to increase the risk of bleeding and hemorrhage [26,27] . A study by Ouriel et al [26] described the complication rates for patients with lower-extremity arterial or venous occlusions treated with local urokinase or rt-PA.…”