Ueda Tatsuo, Saito Hidemasa, Shirai Sayaka, Sugihara Fumie, Fujitsuna Ryutaro, Matsumoto Taiga, Hayashi Hiromitsu, Kumita Shin-Ichiro
Department of Radiology, Nippon Medical School Hospital, Japan.
Interv Radiol (Higashimatsuyama). 2024 Mar 27;10:e20230027. doi: 10.22575/interventionalradiology.2023-0027. eCollection 2025 Mar 28.
Acute portal vein thrombosis is characterized by nonspecific abdominal pain, causing severe morbidity and mortality. Prompt diagnosis is crucial to avoid short-term complications such as intestinal infarction, sepsis, and death. The therapeutic goal is to prevent thrombus extension into the mesenteric veins and intestinal ischemia complications. Systemic anticoagulation is the standard treatment. However, endovascular treatments such as thrombolysis, thrombectomy, balloon angioplasty, stent placement, and transjugular intrahepatic portosystemic shunt placement have been performed in patients who are refractory to anticoagulation therapy or at a high risk of intestinal ischemia. This review discusses the clinical and diagnostic considerations in acute portal vein thrombosis, focusing on current endovascular treatments that are effective and safe. However, prospective data are required to compare endovascular treatment techniques and assess their outcomes.
急性门静脉血栓形成的特征是出现非特异性腹痛,可导致严重的发病率和死亡率。及时诊断对于避免诸如肠梗死、败血症和死亡等短期并发症至关重要。治疗目标是防止血栓扩展至肠系膜静脉并预防肠缺血并发症。全身抗凝是标准治疗方法。然而,对于抗凝治疗无效或存在肠缺血高风险的患者,已经开展了诸如溶栓、血栓切除术、球囊血管成形术、支架置入术以及经颈静脉肝内门体分流术等血管内治疗。本综述讨论了急性门静脉血栓形成的临床和诊断要点,重点关注当前有效且安全的血管内治疗方法。然而,需要前瞻性数据来比较血管内治疗技术并评估其疗效。