S. Muller-hulsbeck et al., Mechanical thrombectomy of acute thrombosis in transjugular intrahepatic portosystemic shunts, INV RADIOL, 35(6), 2000, pp. 385-391
Citations number
37
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
RATIONALE AND OBJECTIVES. To evaluate the feasibility of mechanical thrombe
ctomy with the use of the Amplatz thrombectomy device (ATD) in restoring pa
tency to acutely thrombosed stent-shunts after transjugular intrahepatic po
rtosystemic shunt (TIPS) placement.
METHODS. Mechanical thrombectomy with the ATD was performed in 10 consecuti
ve patients with angiographically documented complete thrombosis of the ste
nt-shunt (mean +/- SD, 6.6 +/- 3.4 cm), which occurred an average of 2.8 mo
nths (range, 0-11 months) after the TIPS procedure.
RESULTS. In all patients, immediate restoration of patency of the stent-shu
nt was achieved after thrombectomy alone (n = 1), thrombectomy plus percuta
neous transluminal angioplasty (PTA; n = 4), and thrombectomy, PTA, and ste
nting (n = 5), The mean activation time of the ATD was 253 +/- 43 seconds.
The pressure gradient for portal decompression decreased from 23 +/- 6 mmHg
before to 11 +/- 3 mmHg after the procedure. The primary patency rate was
80% at 3 months and 60% at 11 months.
CONCLUSIONS. Mechanical thrombectomy with the ATD in acutely thrombosed TIP
S is technically feasible, Mechanical thrombectomy is a potential alternati
ve to thrombolysis.