Local Thrombolysis in Acute and Extended Portal Vein and TIPS Thrombosis in a Patient with Decompensated Cirrhosis and Protein S Deficiency

J Gastrointestin Liver Dis. 2020 Oct 27;29(4):677-680. doi: 10.15403/jgld-1584.

Abstract

This report describes the use of local thrombolysis using a tissue plasminogen activator in a case of a patient with refractory ascites referred for transjugular intrahepatic portosystemic shunt (TIPS) insertion. After successful TIPS insertion, the patient developed acute extended portal vein and TIPS thrombosis, which were treated with local thrombolysis using a tissue plasminogen activator, followed by the complete resolution of ascites. Although there are only limited published data of local thrombolysis for acute splanchnic vein thrombosis, we also review the relevance of the problem in the context of advanced liver disease.

Publication types

  • Case Reports

MeSH terms

  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / therapy
  • Male
  • Middle Aged
  • Portal Vein*
  • Portasystemic Shunt, Transjugular Intrahepatic / adverse effects*
  • Protein S Deficiency / complications*
  • Protein S Deficiency / therapy
  • Thrombolytic Therapy*
  • Tissue Plasminogen Activator / therapeutic use
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / drug therapy*
  • Venous Thrombosis / etiology

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator