TIPS access to portal vein thrombolysis

Objective To evaluate the clinical efficacy of portal venous thrombolysis by way of TIPS. Methods The clinical data of 40 patients with portal venous system thrombosis treated by TIPS at our department from May 2012 to May 2018 were retrospectively analyzed.There were 34 cases of via catheter-directed thrombolysis(7 cases by catheter-directed thrombolysis alone and 27 cases by way of TIPS before catheter-directed thrombolysis ), and 6 cases via pharmaco mechanical thrombectomy(AngioJet); the postoperative complications of the two methods were followed up. Results The portal vein was opened in all 40 patients, and there were no major complications during the operation. One patient in the catheter-directed thrombolysis group developed acute liver failure after surgery.In the mechanical thrombolysis group, 1 patient was discharged after small intestinal necrosis resection and intestinal fistula reconstruction.After 6-24 months of postoperative follow-up, 6 patients in the group of thrombolysis suffered from shunt canal stricture. Conclusions It is a safe and minimally invasive method to treat portal venous system thrombosis through TIPS. Mechanical thrombolysis is more direct and rapid than catheter thrombolysis. Key words: Portal vein; Venous thrombosis; Liver cirrhosis