Risks and benefits of transcatheter thrombolytic therapy in patients with splanchnic venous thrombosis

Jasper H. Smalberg; Manon V. M. C. W. Spaander; Kon-Siong G. Jie; Peter M. T. Pattynama; Henk R. van Buuren; Bart van den Berg; Harry L. A. Janssen; Frank W. G. Leebeek

doi:10.1160/TH08-01-0015

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2008; 100(06): 1084-1088
DOI: 10.1160/TH08-01-0015

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Risks and benefits of transcatheter thrombolytic therapy in patients with splanchnic venous thrombosis

Jasper H. Smalberg

¹Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands

,

Manon V. M. C. W. Spaander

²Department of Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands

,

Kon-Siong G. Jie^#

¹Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands

,

Peter M. T. Pattynama

³Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands

,

Henk R. van Buuren

²Department of Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands

,

Bart van den Berg

⁴Department of Intensive Care, Erasmus University Medical Center, Rotterdam, The Netherlands

,

Harry L. A. Janssen

²Department of Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands

,

Frank W. G. Leebeek

¹Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands

› Author Affiliations

Abstract

Summary

Transcatheter local thrombolytic therapy in patients with acute, extended splanchnic venous thrombosis is controversial. Here we present our single-center experience with transcatheter thrombolytic therapy in these patients. All consecutive patients (n=12) with acute,extended splanchnic venous thrombosis who underwent transcatheter thrombolytic therapy in our hospital, were included in this study. Thrombolytic therapy was successful for three thrombotic events and partially successful for four thrombotic events.Two patients developed minor procedure-related bleeding (17%).Six patients (50%) developed major procedure-related bleeding, with a fatal outcome in two. Transcatheter thrombolytic therapy in patients with acute, extended splanchnic vein thrombosis is found to be associated with a high rate of procedure-related bleeding. Therefore, thrombolysis should be reserved for patients in whom the venous flow cannot be restored by using conventional anticoagulant therapy or stent placement across the thrombosed vessel segment.

H.L.A. Janssen and F.W.G. Leebeek are both Clinical Fellows of the Netherlands Organisation for Scientific Research (NWO).

Keywords

Thrombosis (venous) - portal vein thrombosis - Budd-Chiari syndrome - thrombolytic therapy - rtPA

Full Text

References

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