Published online Nov 7, 2017. doi: 10.3748/wjg.v23.i41.7470
Peer-review started: July 25, 2017
First decision: August 30, 2017
Revised: September 10, 2017
Accepted: September 29, 2017
Article in press: September 28, 2017
Published online: November 7, 2017
Processing time: 104 Days and 20.9 Hours
Acute portal vein thrombosis is a common complication of cirrhosis and would lead to adverse prognosis. Endovascular selective catheterization thrombolytic therapy and transjugular intrahepatic portosystemic shunt has been increasingly successfully implemented, which brings new opportunities for the treatment of acute portal vein thrombosis (PVT).
The aim of this study was to compare the clinical outcomes of transcatheter selective superior mesenteric artery (SMA) urokinase infusion therapy and transjugular intrahepatic portosystemic shunt (TIPS) in patients with cirrhosis and acute PVT to evaluate their effectiveness and safety for acute PVT.
To evaluate the effectiveness and safety of transcatheter selective SMA urokinase infusion therapy and TIPS in patients with cirrhosis and acute PVT to provide theoretical support for the implementation of new therapies.
A randomized controlled trial was performed, and the total follow-up time was 24 mo. The outcome measures were the change in portal vein patency status, rebleeding, and hepatic encephalopathy.
Both treatments can quickly relieve symptoms within 48 h. The main portal vein thrombosis was significantly reduced in both groups and there was no significant difference between them. No fatal complications occurred.
Transcatheter SMA infusion therapy and TIPS are both safe and effective treatments for patients with cirrhosis and acute PVT, particularly for grade I and II PVT, and transcatheter SMA urokinase infusion therapy is more ideal for the treatment of fresh thrombus in the mesentery.
Further large-scale studies are needed. It is better to have a separate anticoagulant group as a control.