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Vascular and Endovascular Surgery
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Catheter-Directed Thrombolytic Therapy in a Patient with Portal Venous Thrombosis Following Splenectomy—

A Case Report

Koki Tanaka

Second Department of Surgery, Kagoshima University School of Medicine, Kagoshima, Japan

Takashi Ohno

Second Department of Surgery, Kagoshima University School of Medicine, Kagoshima, Japan

Shunpei Nishi

Second Department of Surgery, Kagoshima University School of Medicine, Kagoshima, Japan

Riichiro Toda

Second Department of Surgery, Kagoshima University School of Medicine, Kagoshima, Japan

Akira Taira

Second Department of Surgery, Kagoshima University School of Medicine, Kagoshima, Japan

A case of mesenteric venous thrombosis following splenectomy is presented. Her postoperative course was complicated. On the twentieth postoperative day, complete obstruction of the portal trunk was observed on portography. Cathe ter-directed thrombolytic therapy was started immediately. A total of 390 x 104 IU urokinase was given into the portal vein for eighteen days. After this ther apy, marked clinical improvement was noted and complete lysis of the thrombus was obtained. The portal system from trunk to intrahepatic branch was recana lized. This method had some benefits of efficacy, safety, and economy. To our knowledge, this is the first case of portal venous thrombosis to be successfully treated by catheter-directed thrombolytic therapy.

Vascular and Endovascular Surgery, Vol. 26, No. 6, 509-514 (1992)
DOI: 10.1177/153857449202600613
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