NONCAVERNOMATOUS PORTAL-VEIN THROMBOSIS IN HEPATIC CIRRHOSIS - TREATMENT WITH TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT AND LOCAL THROMBOLYSIS

PURPOSE: To evaluate the use of the transjugular intrahepatic portosys temic shunt (TIPS) and local, low-dose thrombolysis in the treatment o f complete, noncavernomatous portal vein occlusion. MATERIALS AND METH ODS: TIPS implantation and portal vein recanalization was attempted in seven patients with noncavernomatous portal vein obstruction and recu rrent variceal bleeding. TIPS placement was followed by thrombolytic t herapy to restore portal venous blood flow. Hemodynamic effects and cl inical characteristics after the procedure and during follow-up were a ssessed. RESULTS: The implantation of TIPS and the recanalization of t he portal vein trunk were successful in all patients. The treatment re duced the portal venous pressure gradient and restored portal blood fl ow. No bleeding complications were observed. CONCLUSION: TIPS placemen t and recanalization of the main portal vein is a safe and effective t reatment option for patients with liver cirrhosis and noncavernomatous portal vein occlusion.