Transhepatic fibrinolysis of mesenteric and portal vein thrombosis in a patient with ulcerative colitis: A case report

Table 1 Acute mesenterico-portal thrombosis treated with local thrombolytic therapy.

Author	Year	Etiology	Thrombus site	Access	Treatment	Complications	Outcome
Yankes JR	1988	Pancreatic cancer	Superior mesenteric vein (SMV)	Transhepatic	Urokinase for 4 h then angioplastic dilatation and systemic heparin	Laparotomy with ileal resection 2 wk after treatment	Thrombus resolution
Bilbao JI	1989	Splenectomy	Portal vein (PV) and SMV	Tranhepatic	Urokinase for 12 h then systemic heparin	None	Thrombus resolution
Demertzis S	1994	Non noted	PV and SMV	Mesenteric	Surgical thrombectomy, reintervention, local rTPA for 48 h then local heparin for 4 d	None	Thrombus resolution
Miyazaki Y	1995	Ulcerative colitis	PV and PV branches	Transhepatic	Systemic urokinase and local rTPA for 30’ then urokinase for 6 d	None	Thrombus resolution
Poplausky MR	1996	Gastric cancer	Portal and superior mesenteric vein	Arterial	Urokinase for 48 h with systemic heparin	None	Partial thrombus
Tsuijikawa T	1996	Crohn’s disease	PV, SMV and splenic vein (SV)	Arterial	rTPA 1 h and urokinase for 14 d and systemic heparin and serin-protease inhibitors	None	Thrombus resolution resolution
Ludwig DJ	1999	Protein S deficiency	PV, SMV, and SV	Arterial	Urokinase for 4 d and systemic heparin	None	Thrombus resolution
Sze DY	2000	Protein S deficiency	PV, right PV branch, SMV and SV	Arterial	Urokinasefor 16 h and sistemic heparin	GI bleeding, exploratory laparotomy and jejunum resection	Thrombus resolution after transjugular mechanical thrombolysis
Antoch G1	2001	Protein C deficiency (n = 1)	PV and SMV	Arterial	Urokinase for 8 d then systemic heparin	Bleeding at the catheter site after 5 d of therapy in one case	Thrombus resolution (?)
Tateishi A	2001	Down syndrome and protein S deficiency	Pv, SMV and SV	Arterial	Systemic thrombolysis, with heparin sc, than local urokinase for 11 d	Evolution to portal cavernoma	Reduction of the thrombus
Aytekin C	2001	Chronic Pancreatitis	Partial PV	Transhepatic	4 cycles of systemic thrombolysis, then local thrombolysis with urokinase	None	Thrombus resolution
Kercher KW	2002	Splenectomy	PV, PV branches, SMV and SV	Transjugular	Local thrombolysis: mechanical attempt followed by urokinase for 45 h, then systemic heparin	Epistaxis and hematuria	Persistent thrombus in the right PV branch and PV partial occlusion

(¹3 cases).