RESEARCH ARTICLE


Systemic Thrombolysis of Acute Portal Venous System Thrombosis in Patients with Liver Cirrhosis: A Pilot Study



Samah Soliman1, Ahmed Mohamed Ismail2, Rehab Badawi1, *, Walaa Elkhalawany1
1 Tropical Medicine And Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt
2 Vascular and Endovascular Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt


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Creative Commons License
© 2024 The Author(s). Published by Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Tropical Medicine And Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt; E-mail: rehab.elsheshtawy@med.tanta.edu.eg


Abstract

Background

The prevalence of Portal Vein Thrombosis (PVT) is highly variable at different stages of liver disease: in compensated patients 10%, in decompensated patients 17%, in acute decompensated cirrhosis 9%, and in post-liver transplantation patients 2-26%.

Aim

The aim of the study was to assess the efficacy and safety of systemic thrombolysis in acute portal vein thrombosis in patients with liver cirrhosis.

Methods

A total of 10 compensated cirrhotic patients with acute portal vein thrombosis were examined by abdominal ultrasonography with color Doppler and Contrast-enhanced computerized tomography. Continuous intravenous infusion of recombinant tissue plasminogen activator(r-tPA.) and Low molecular weight heparin (LMWH) was used to treat all patients for a maximum of 7 days. Patients were followed up for improvement of clinical symptoms and radiological by abdominal ultrasound with color Doppler and contrast-enhanced computerized tomography.

Results

The regimen of therapy was found to be well-tolerated by all the patients. At the end of the seven days, six patients (60%) had full recanalization of the portal vein, while three had partial recanalization (30%) and no recanalization in only one patient (10%).

Conclusion

The preliminary data indicate that systemic thrombolytic therapy combined with low molecular weight heparin for the treatment of PVT appears to be safe and effective over a few days with no clinically significant side effects.

Keywords: Liver cirrhosis, Acute portal vein thrombosis, Systemic thrombolytic therapy, Liver transplantation, PVT, MV.