Large Bore Portal Vein Thrombectomy: An Inari FlowTriever Case Series.

Abstract

PURPOSE:

Portal vein thrombus (PVT) can worsen portal hypertension and hepatic decompensation in patients with cirrhosis and impact liver transplant outcomes. This retrospective case series describes large bore mechanical thrombectomy of PVT with the Inari FlowTriever device during, or remotely after, transjugular intrahepatic portosystemic shunt (TIPS) placement.

MATERIALS AND METHODS:

Ten patients with PVT were treated with large bore thrombectomy. All patients had underlying cirrhosis, complicated by portal hypertension with acute/subacute PVT. Thrombectomy was performed either with TIPS placement, or via a previously placed thrombosed shunt. Median time from TIPS placement to thrombectomy was 3 years.

RESULTS:

Thrombectomy was technically successful in all patients with a majority achieving complete resolution of PVT in a single session. During mean follow-up of 13.3 months, all patients achieved complete resolution of PVT without recurrence.

CONCLUSION:

Large bore mechanical thrombectomy together with TIPS is a feasible and effective treatment of acute/subacute PVT in cirrhotic patients with portal hypertension, often with complete resolution in a single session.

• Authors: Ian W Sullivan, Adam Fonseca, McKenzie Brown, Joseph Ness, Marc Borge, Parag Amin, Christopher Molvar
• Journal: Cardiovascular and interventional radiology (Cardiovasc Intervent Radiol) Vol. 46 Issue 1 Pg. 136-141 (Jan 2023) ISSN: 1432-086X [Electronic] United States
• PMID: 36261506 (Publication Type: Journal Article)
• Copyright: © 2022. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).

Topics

• Humans
• Portal Vein (surgery, pathology)
• Portasystemic Shunt, Transjugular Intrahepatic (adverse effects)
• Retrospective Studies
• Venous Thrombosis (diagnostic imaging, surgery, complications)
• Thrombosis (complications)
• Thrombectomy (adverse effects)
• Hypertension, Portal (complications, surgery)
• Liver Cirrhosis (etiology)
• Treatment Outcome