Portal Vein Thrombosis Treatment

Portal Vein Thrombosis Treatment

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Portal vein thrombosis (PVT) is a serious medical condition which can be fatal and lead to other serious health complications. A PVT is basically a clot that occurs in the portal vein (a vein which connects the liver and spleen & gastrointestinal tract. It must be managed and treated immediately as soon as possible to prevent further damage.

Portal vein thrombosis treatment

For portal vein thrombosis treatment, the most important thing to do is maintain vital signs, such as maintain blood pressure, pulse, breathing etc.

Here are the portal vein thrombosis treatments:

Stop Bleeding

In PVT, especially if it is an acute PVT, bleeding may occur. Bleeding can be presented as vomiting up with blood, drop in blood pressure and pulse. Bleeding should be stopped as soon as possible and blood fluid levels maintained. A blood transfusion is administered to maintain blood levels and surgery (laparotomy) may be required to stem the flow of blood loss.

Sclerotherapy

Sclerotherapy or variceal banding where a sclerosing solution is injected into the vein to stop bleeding of the vein if it occurs. This has a high success rate of 95% using this technique for portal vein bleeding. This method is only used if there is bleeding, not for removing the thrombosis or clot.

Thrombolysis

Thrombolysis is a technique where thrombolytic medication is used to dissolve the clot. The medication used mostly with PVT is Tissue-type plasminogen (tPA). Unfortunately, there is serious side effects with this medication. This medication can cause severe bleeding which can be fatal and cause permanent health effects.

Anticoagulant Therapy

People who have an acute PVT will usually have a 3 month period of anticoagulant therapy. The medication often used is Coumadin or Wafarin. For people who have chronic PVT or has a history of coagulation disorders are on anticoagulants for the rest of their lives. Side effects with this therapy is bleeding which can be severe.

Shunt surgery

If bleeding or thrombosis cannot be treated in any other way, than shunt surgery may be indicated. It has a high mortality rate of approximately 2 per cent and complications after surgery shooting up to 30 per cent.

Transjugular Intrahepatic Portosystemic Shunt (TIPS)

TIPS is a procedure where a catheter is inserted through your vein where a balloon blows up the vein in your hepatic vein to place a stent there. An embolectomy (removal of clot) and thrombolytic therapy may be also used to treat the clot. This procedure requires a lot of skill and technique and has a high mortality rate of 22 per cent.

Liver Transplant

People who liver cirrhosis or liver failure are a good candidate for a liver transplant. Unfortunately, this too comes with many complications such as organ rejection, necrosis, infection and many other issues. Also, there is a lack of donors for livers which is very hard to come by.

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