Early catheter-directed portal vein thrombolysis in myeloproliferative disorder-related diffuse mesenteric venous ischemia: A case report

doi:10.3748/wjg.v32.i4.114906

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Jan 28, 2026 (publication date) through Jan 23, 2026

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jan 28, 2026; 32(4): 114906
Published online Jan 28, 2026. doi: 10.3748/wjg.v32.i4.114906

Table 1 Laboratory parameters and medications during hospitalization

Parameter	Time to treatment initiation (days)
Parameter	D - 0	D + 1	D + 2	D + 3	D + 4	D + 5	D + 6	D + 7	D + 8	D + 13	D + 15
CDT with urokinase (U/hour)		12000	12000	12000	14000	16000	16000	16000	12000	10000	Off
Systemic anticoagulant
Heparin pump (U/hour)	440	440	320	320	200	Off
Oral apixaban						2.5 mg twice/day
Fibrinogen (mg/dL)		684	501	624	624	551			342	460	668
APTT (second)	32.8	44.9	38.2	35.9	39.6	41.5	41.3	36.0	45.5		39.8
Lactate (mmol/L)	2.2	2.5	1.6	1.0	0.7	0.9
CK (U/L)	57		47	220	195				76	48
WBC (10³/μL)	12480	14180	12030	10830	10720	8980			11110	9140	8570
Hemoglobin (g/dL)	18.8	17.0	13.7	13.5	13.4	12.4			13.7	11.1	11.4
CRP (mg/dL)	11.10		10.58		1.77	3.85	4.30
Imaging				Abdominal CT					Venography		Venography

D - 0 indicates the day of presentation to the Department of Emergency and the initiation of treatment; D + indicates the number of days after initiation of treatment. APTT: Activated partial thromboplastin time; CDT: Catheter-direct thrombolysis; CK: Creatine kinase; CRP: C-reactive protein; WBC: White blood cell.

Full Size Table

Table 2 Clinical and therapeutic parameters of portal vein thrombolysis, including the catheter access method, recanalization, and complication rate

Ref.	Case	MPD (%)	Total occlusive PVT	CDT timing (day)	CDT		Complete recanalization rate, AC/CDT (%)	Failure rate, AC/CDT (%)	Bleeding complications[13]
Ref.	Case	MPD (%)	Total occlusive PVT	CDT timing (day)	Transhepatic approach	TIPS	Complete recanalization rate, AC/CDT (%)	Failure rate, AC/CDT (%)	Grade 1/2, AC/CDT (%)	Grade 3/4, AC/CDT (%)	Death, AC/CDT (%)
Rössle et al[7], 2020	65	23	52	8.9		35	30.0/54.0	15.0/14.3	0/22.5	0/2.5	0/0
Benmassaoud et al[8], 2019	22	22.7	17	4		11	13.7/70.0	63.6/9.1	Total 318	0/18.1	0/0
Wu et al[9], 2025	25	12	18	6		25	-/48	-/16	-/16	0/0	0/0
Klinger et al[10], 2017	29	20.7	16	7		17	-/52.9	-/11.8	-/5.9	-/0	-/0
Mansour et al[11], 2022	21	14.3	14	13	9	12	-/35.0	9.5	-/23.8	-/19.0	-/1.0
Gerwing et al[12], 2019	8	0	5	0	6	2	-/62.5	-/12.5	-/12.5	-/37.5	-/1.0

AC: Anticoagulation; CDT: Catheter-direct thrombolysis; MPD: Mesenteric/portal vein thrombosis; PVT: Portal vein thrombosis; TIPS: Transjugular intrahepatic portosystemic shunt.

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Citation: Chiu YC, Chang WC, Chiu YC. Early catheter-directed portal vein thrombolysis in myeloproliferative disorder-related diffuse mesenteric venous ischemia: A case report. World J Gastroenterol 2026; 32(4): 114906
URL: https://www.wjgnet.com/1007-9327/full/v32/i4/114906.htm
DOI: https://dx.doi.org/10.3748/wjg.v32.i4.114906