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Systemic thrombolysis of portal vein thrombosis in cirrhotic patients: A pilot study
- Publication Year :
- 2010
- Publisher :
- ELSEVIER SCIENCE INC, 2010.
-
Abstract
- Background Portal vein thrombosis is a frequent complication in liver cirrhosis. Encouraging reports of systemic thrombolysis in non-cirrhotic patients suffering from acute portal vein thrombosis led us to start a pilot study on the efficacy and safety of systemic low dose recombinant tissue plasminogen activator (Actilyse®, Boheringer Ingelheim, Florence, Italy). Patients Nine cirrhotic patients (6 males and 3 females) with recent portal vein thrombosis were enrolled. Exclusion criteria were portal cavernomatosis, recent (30 days) surgery, active bleeding, hepatocellular carcinoma and cancer in other sites. Methods All cases were treated for a maximum of 7 days by continuous i.v. infusion of 0.25 mg/kg/die of r-tPA plus subcutaneous low molecular weight heparin. Efficacy was evaluated by colour doppler sonography monitoring and confirmed by contrast enhanced computerized tomography. Results The combined r-tPA/LMWH treatment was well tolerated without clinically significant side effects. Complete resolution of thrombosis occurred in 4 cases, partial regression in 4 and none in 1. Retreatment of a complete recurrence in 1 patient was successful. Variceal pressure dropped from 30.7 ± 4.5 mmHg to 21.2 ± 6.6 mmHg (p = 0.012). Conclusions Our preliminary data demonstrate that thrombolytic treatment of recent portal vein thrombosis with i.v. r-tPA and LMWH in patients with cirrhosis appears to be safe and effective and can significantly reduce pressure in oesophageal varices.
- Subjects :
- Adult
Liver Cirrhosis
Male
medicine.medical_specialty
Cirrhosis
medicine.drug_class
Injections, Subcutaneous
medicine.medical_treatment
Low molecular weight heparin
Pilot Projects
thrombolysis
r-tpa
portal vein thrombosis
cirrhosis
Fibrinolytic Agents
medicine
Humans
Thrombolytic Therapy
Ultrasonography, Doppler, Color
Infusions, Intravenous
Aged
Retrospective Studies
Venous Thrombosis
Dose-Response Relationship, Drug
Hepatology
Portal Vein
business.industry
Gastroenterology
Heparin
Thrombolysis
Heparin, Low-Molecular-Weight
Middle Aged
medicine.disease
Thrombosis
Portal vein thrombosis
Surgery
Treatment Outcome
Tissue Plasminogen Activator
Female
Tomography, X-Ray Computed
business
Complication
Varices
Venous Pressure
Blood Flow Velocity
Follow-Up Studies
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....c3857b0fe2d1cba6811242ed3e042cef