A recent study explored the use of systemic thrombolysis for treating acute portal vein thrombosis (PVT) in patients with liver cirrhosis, a condition with varying prevalence depending on the stage of liver disease. PVT affects approximately 10% of compensated cirrhotic patients, 17% of those with decompensated cirrhosis, 9% of acute decompensated cases, and ranges from 2% to 26% in post-liver transplant patients. The study evaluated the effectiveness and safety of combining recombinant tissue plasminogen activator (r-tPA) with low molecular weight heparin (LMWH) for this purpose.
Ten compensated cirrhotic patients with acute PVT underwent treatment and were monitored through abdominal ultrasound with color Doppler and contrast-enhanced CT scans. Patients received continuous intravenous infusions of r-tPA and LMWH for up to seven days. The primary outcomes were clinical improvement and radiological changes assessed through the imaging techniques mentioned. Results showed that the therapy was well-tolerated, with no significant adverse effects reported among the participants. After the treatment period, six patients (60%) experienced full recanalization of the portal vein, three patients (30%) achieved partial recanalization, and one patient (10%) showed no recanalization.
These preliminary findings indicate that systemic thrombolytic therapy, when combined with low molecular weight heparin, may be a safe and effective approach for treating acute PVT in cirrhotic patients over a short timeframe. The study suggests that this therapeutic approach has potential as a viable option for PVT management, though further research is needed to validate these results across broader patient groups and longer follow-up periods.
