Treatment of Portal Vein Thrombosis

In acute portal vein thrombosis, the main treatment goals are:

• Prevent the clot from increasing in size.
• Prevent intestinal infarction, which occurs when the intestines do not receive enough blood.
• Try to recanalise the vein (unblock it).
• Prevent portal vein hypertension (increased blood pressure in the portal vein).

In chronic portal vein thrombosis, the goal of anticoagulation is to:

• Prevent the thrombosis from progressing.
• Prevent clots from forming in other parts of the body.
• Assess whether complications of portal vein hypertension that can develop over time should be treated or prevented.

If a specific cause of the thrombosis is detected (such as an underlying disease), it will be evaluated if a specific treatment for that condition is necessary.

In these situations, surgery is necessary to:

• Remove damaged tissue from the intestines.
• Restore blood flow to the intestines.
• Prevent serious complications such as intestinal perforation or widespread infection (sepsis).

Save the intestine and prevent the condition from worsening in an emergency operation.

Key aspects of the procedure:

• Individual assessment. Before performing the procedure, a multidisciplinary team of professionals (e.g. doctors specialising in gastroenterology, surgery, radiology or internal medicine) evaluates each case individually to determine if the operation is appropriate and safe for the patient.
• Interventional radiology techniques. The aim of these techniques is to improve blood flow and reduce pressure in the portal vein by inserting a stent (an expandable mesh to open blocked veins) or forming a shunt (a new path for the blood).

This type of treatment can help control complications associated with portal hypertension and prevent further damage to affected organs.