ACUTE THROMBOSIS OF THE PORTAL VENOUS SYS TEM - SYSTEMIC TREATMENT WITH HEPARIN AND A RECOMBINANT TISSUE-PLASMINOGEN ACTIVATOR OR HEPARIN ALONE IN 10 PATIENTS

Objectives. - We report the efficacy of alteplase (a recombinant tissu e plasminogen activator) with heparin or herparin alone in the treatme nt of acute thrombosis of the portal venous system. Methods. - Ten con secutive patients with acute portal venous system thrombosis were stud ied. Five patients were treated with alteplase and heparin, and the re maining 5 patients, who were asymptomatic or had a contraindication to alteplase, were treated with heparin alone. Results. - In 3 of the 5 patients treated with alteplase, ultrasonography showed total resoluti on of the thrombus; the remaining 2 had partial resolution of the thro mbus. In 4 of the 5 patients treated with heparin alone, ultrasonograp hy showed total resolution of the thrombus, and no change in one. No b leeding occurred. Conclusion. - Treatment with heparin can result in c omplete recanalisation of acute portal venous system thombosis. These data suggest that combined therapy with systemic alteplase does not in crease the efficacy of heparin.