What iS pORTAL vEIN tHROMBOSIS

The portal veins carry blood from the bowels and spleen to the liver to be filtered before returning to the circulation throughout the body. Blood clots can form in these veins causing abnormal pressure in the veins upstream. In the acute setting, this can cause damage to the bowel and even the bowel to die, which is life threatening. Chronically, it can cause chronic abdominal pain that worsens with eating and abnormal blood vessels called “varices” that can rupture causing life-threatening bleeding. Portal vein throbosis is most commonly cause by cirrhosis (scarring of the liver) or certain conditions that make people prone to forming blood clots.

Portal vein recanalization

Acute portal vein thrombus is often treated with blood thinners. However, this is not always successful in getting rid of the blood clot or doing so fast enough to save the bowel. When acute, the clot can be broken up or sucked out through a pinhole in the neck or side. When chronic, the veins can sometimes be reopened with small balloons through pinholes in the neck and side. This often also requires creating a tunnel through the liver to help blood flow through the reopened veins. This tunneled is called a “transjugular intrahepatic portosystemic shunt” or “TIPS.”

What are the risks and recovery of Portal Vein Recanalization?

In the acute setting, most people are already admitted to the hospital. In the chronic setting, most people spend the night after the procedure in the hospital for monitoring. Although the procedure is minimally invasive is does have ~5% risk of major complication such as causing liver failure, major bleeding, or even death. More often though people may have some temporary abdominal pain afterwards.