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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
1   Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
,
Manon V. M. C. W. Spaander
2   Department of Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
,
Kon-Siong G. Jie   #
1   Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
,
Peter M. T. Pattynama
3   Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
,
Henk R. van Buuren
2   Department of Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
,
Bart van den Berg
4   Department of Intensive Care, Erasmus University Medical Center, Rotterdam, The Netherlands
,
Harry L. A. Janssen
2   Department of Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
,
Frank W. G. Leebeek
1   Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

Received: 09 January 2008

Accepted after major revision: 19 September 2008

Publication Date:
23 November 2017 (online)

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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

# Current address: Atrium Medical Center, Heerlen, The Netherlands.


 

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