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Current Gastroenterology Reports
Published in: Current Gastroenterology Reports 12/2021

01-12-2021 | Portal Vein Thrombosis | Liver (S Cotler and E Kallwitz, Section Editors)

Portal Vein Thrombosis In Cirrhosis: Interventional Treatment Options

Authors: Christopher Molvar, Parag Amin

Published in: Current Gastroenterology Reports | Issue 12/2021

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Abstract

Purpose of Review

Portal vein thrombosis (PVT) is a frequent consequence of cirrhosis and its management is variable and controversial. Herein we highlight interventional treatment options and outcomes, together with mention of the physiology, presentation and imaging of PVT.

Recent Findings

Utilization of transjugular intrahepatic portosystemic shunt (TIPS) for acute and chronic PVT is expanding. In acute PVT, TIPS improves hepatopetal flow which promotes thrombus resorption and prevents rethrombosis. The TIPS also functions as a conduit for thrombectomy devices and allows for embolization of variceal shunts. Chronic PVT is a relative contraindication to liver transplant. Portal vein recanalization (PVR) TIPS restores flow in a previously occluded portal vein, allowing for a conventional end-to-end portal vein anastomosis at transplant. PVR TIPS is technically demanding and often requires percutaneous splenic vein access for portal venous recanalization.

Summary

Selection of endovascular PVT treatment varies with the age (acute or chronic) and the extent of thrombus, along with presenting symptoms and transplant candidacy.
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Metadata
Title
Portal Vein Thrombosis In Cirrhosis: Interventional Treatment Options
Authors
Christopher Molvar
Parag Amin
Publication date
01-12-2021
Publisher
Springer US
Published in
Current Gastroenterology Reports / Issue 12/2021
Print ISSN: 1522-8037
Electronic ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-021-00826-1

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