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Portal vein thrombosis (PVT) is a vascular disease of the liver that occurs when a blood clot occurs in the hepatic portal vein, which can lead to increased pressure in the portal vein system and reduced blood supply to the liver. The mortality rate is approximately 1 in 10.
Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. [3] [4] Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5–9 mmHg; clinically significant portal hypertension is present at portal pressures greater than 10 mmHg. [5]
Preoperative PVE is a very well tolerated procedure with extremely low mortality rates (0.1 percent) and technical failure rates (0.4 percent). [3] Complication rates from the procedure are low as well (2–3 percent) and include portal vein thrombosis, liver infarction, necrosis, infection, pneumothorax, and other risks as listed above. [3]
Segmental occlusions of the inferior vena cava or portal vein can be treated with percutaneous transluminal angioplasty in which a balloon is passed via a guidewire to the site of the venous obstruction and then inflated to open the blockage, this may be followed by stent placement (either immediate stent placement or deferred (when the stent ...
Venous thromboembolism and superficial vein thrombosis account for about 90% of venous thrombosis. Other rarer forms include retinal vein thrombosis, mesenteric vein thrombosis (affecting veins draining blood from the gastrointestinal organs), cerebral venous sinus thrombosis, renal vein thrombosis, and ovarian vein thrombosis. [3]
Treatment generally includes supportive care including pain management and possibly diuretics. [5] In those with severe disease due to a bone marrow transplant, defibrotide is a proposed treatment. [6] It has been approved for use in severe cases in Europe and the United States. [7] [8] A placebo controlled trial, however, has not been done as ...
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