Mesenteric and Portal Venous Thrombosis Treated by Transjugular Mechanical Thrombolysis
Daniel Y. Sze1,
Gerard J. O'Sullivan1,2,
Denise L. Johnson3 and
Michael D. Dake1
1
Division of Cardiovascular and Interventional Radiology, Stanford University
Medical Center, 300 Pasteur Dr., Ste. H3600, Stanford, CA 94305-5642.
2
Present address: Division of Vascular and Interventional Radiology,
Rush-Presbyterian-St. Luke's Medical Center, 1725 W. Harrison St., Ste. 400,
Chicago, IL 60612.
3
Department of General Surgery, Stanford University Medical Center, Stanford,
CA 94305-5655.

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Fig. 1A. 37-year-old man with spontaneous splanchnic and portal venous
thromboses. CT scan obtained at presentation shows thrombosed main trunk of
superior mesenteric vein (arrow). Note thick-walled ischemic jejunum
(arrowheads).
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Fig. 1B. 37-year-old man with spontaneous splanchnic and portal venous
thromboses. Venous phase of splenic arteriogram shows thrombus in main portal
vein (arrow) and no inflow from superior mesenteric vein. Note
occlusion of anterior right portal vein (arrowhead).
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Fig. 1C. 37-year-old man with spontaneous splanchnic and portal venous
thromboses. Transjugular superior mesenteric venogram obtained after bowel
resection and manual expression of superior mesenteric vein branch thrombus
confirms complete occlusion and poor collateral drainage.
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Fig. 1D. 37-year-old man with spontaneous splanchnic and portal venous
thromboses. Splenic venogram obtained after thrombolysis shows flow into left
portal vein.
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Fig. 1E. 37-year-old man with spontaneous splanchnic and portal venous
thromboses. CT scan obtained 12 days after thrombolysis shows patent superior
mesenteric vein (arrow).
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