Kun Liu1, Wen-Dong Li2, Xiao-Long Du2, Cheng-Long Li3, Xiao-Qiang Li4. 1. Department of Vascular Surgery, The Second Affiliated Hospital of Soochow University, Jiangsu, China; Department of Vascular Surgery, The Suqian People's Hospital affiliated to Nanjing Drama Tower Hospital Group, Jiangsu, China. 2. Department of Vascular Surgery, The Second Affiliated Hospital of Soochow University, Jiangsu, China. 3. Department of Vascular Surgery, The Second Affiliated Hospital of Soochow University, Jiangsu, China. Electronic address: lcljm11@163.com. 4. Department of Vascular Surgery, The Second Affiliated Hospital of Soochow University, Jiangsu, China. Electronic address: flytsg@126.com.
Abstract
BACKGROUND: The aim of this study was to evaluate the safety and efficacy of indirect thrombolysis via the superior mesenteric artery (SMA) in patients with acute portal vein thrombosis. METHODS: Over 10 years, we studied the safety and efficacy of indirect thrombolysis via the SMA in 34 patients with acute portal vein thrombosis. Eighteen patients were categorized as the systemic thrombolysis (ST) group and 16 as the catheter thrombolysis (CT) group. The ST group was administered low-molecular-weight heparin, and patients in the CT group received catheter thrombolysis. Clinical data, such as comorbidities, laboratory test results, therapeutic methods, and prognosis, were recorded. All the patients underwent a routine clinical follow-up that was performed by inpatient examinations or outpatient visits at a mean follow-up time of 34 months. RESULTS: The thrombus score was significantly higher in the ST group (3.67 ± 1.19) than in the CT group (2.38 ± 0.62) after 2 weeks of treatment (P < 0.05). The average period of symptom alleviated was longer in the ST group (3.29 ± 1.59 days) than in the CT group (2.07 ± 0.73 days, P < 0.05). Five patients (4 in the ST group and 1 in the CT group) underwent a laparotomy because of peritonitis after thrombolysis for 24 hr. One patient died of a malignant tumor after 18 months. CONCLUSIONS: Indirect thrombolysis via the SMA is safer and more effective for patients with portal vein thrombosis compared with systemic thrombolysis.
BACKGROUND: The aim of this study was to evaluate the safety and efficacy of indirect thrombolysis via the superior mesenteric artery (SMA) in patients with acute portal vein thrombosis. METHODS: Over 10 years, we studied the safety and efficacy of indirect thrombolysis via the SMA in 34 patients with acute portal vein thrombosis. Eighteen patients were categorized as the systemic thrombolysis (ST) group and 16 as the catheter thrombolysis (CT) group. The ST group was administered low-molecular-weight heparin, and patients in the CT group received catheter thrombolysis. Clinical data, such as comorbidities, laboratory test results, therapeutic methods, and prognosis, were recorded. All the patients underwent a routine clinical follow-up that was performed by inpatient examinations or outpatient visits at a mean follow-up time of 34 months. RESULTS: The thrombus score was significantly higher in the ST group (3.67 ± 1.19) than in the CT group (2.38 ± 0.62) after 2 weeks of treatment (P < 0.05). The average period of symptom alleviated was longer in the ST group (3.29 ± 1.59 days) than in the CT group (2.07 ± 0.73 days, P < 0.05). Five patients (4 in the ST group and 1 in the CT group) underwent a laparotomy because of peritonitis after thrombolysis for 24 hr. One patient died of a malignant tumor after 18 months. CONCLUSIONS: Indirect thrombolysis via the SMA is safer and more effective for patients with portal vein thrombosis compared with systemic thrombolysis.
Authors: Eva Montalvá; Manuel Rodríguez-Perálvarez; Annabel Blasi; Santiago Bonanad; Olga Gavín; Loreto Hierro; Laura Lladó; Elba Llop; Juan Carlos Pozo-Laderas; Jordi Colmenero Journal: Transplantation Date: 2022-01-04 Impact factor: 5.385