{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T09:33:27Z","timestamp":1792748007371,"version":"4.5.0"},"reference-count":57,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rofo"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>\n            Background\u2002Portal vein thrombosis (PVT) is a rare but severe entity that can cause clinically significant sequela such as worsening portal hypertension or mesenteric ischemia. Those cases refractory to medical management may be referred for endovascular intervention. Several technical considerations have been described in the literature, but a cohesive comparison of these multiple techniques is lacking.<\/jats:p><jats:p>\n            Methods\u2002The purpose of this article is to review the diagnosis and endovascular management of PVT, including areas in which further research is warranted.<\/jats:p><jats:p>\n            Results\u2002Cases of PVT can be readily diagnosed using ultrasound, computed tomography, or magnetic resonance imaging. Treatment often begins with systemic anticoagulation and endovascular interventions may be used in selected cases. Determining the optimal approach to accessing the portal venous system depends on the underlying disease and chronicity of the thrombus and the degree of occlusion. Once access to the portal venous system is established, catheter-directed therapy may be performed to achieve recanalization.<\/jats:p><jats:p>\n            Conclusion\u2002Despite the heterogeneity in patient presentation, cases of PVT can be readily diagnosed across several imaging modalities. Strategizing interventional approaches involves evaluation of the underlying disease and the chronicity of the thrombus.<\/jats:p><jats:p>\n            Key Points:\u2002<\/jats:p><jats:p>\n            Citation Format\n          <\/jats:p>","DOI":"10.1055\/a-1642-0990","type":"journal-article","created":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T22:50:53Z","timestamp":1634251853000},"page":"169-180","source":"Crossref","is-referenced-by-count":29,"title":["Portal Vein Thrombosis: Diagnosis and Endovascular Management"],"prefix":"10.1055","volume":"194","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5538-4086","authenticated-orcid":false,"given":"Connie","family":"Ju","sequence":"additional","affiliation":[{"name":"Radiology, University of California Los Angeles Health System, Los Angeles, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Radiology, University of Pennsylvania Health System, Philadelphia, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Gadani","sequence":"additional","affiliation":[{"name":"Interventional Radiology, Cleveland Clinic Foundation, Cleveland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baljendra","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Interventional Radiology, Cleveland Clinic Foundation, Cleveland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasan","family":"Partovi","sequence":"additional","affiliation":[{"name":"Interventional Radiology, Cleveland Clinic Foundation, Cleveland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.3748\/wjg.v12.i13.2115","article-title":"Portal vein thrombosis: Prevalence, patient characteristics and lifetime risk: A population study based on 23796 consecutive autopsies","volume":"12","author":"M \u00d6gren","year":"2006","journal-title":"World J Gastroenterol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"443","DOI":"10.4254\/wjh.v7.i3.443","article-title":"Endothelial dysfunction in cirrhosis: Role of inflammation and oxidative stress","volume":"7","author":"B Vairappan","year":"2015","journal-title":"World J Hepatol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.jhep.2019.02.015","article-title":"Current knowledge in pathophysiology and management of Budd-Chiari syndrome and non-cirrhotic non-tumoral splanchnic vein thrombosis","volume":"71","author":"V Hernandez-Gea","year":"2019","journal-title":"J Hepatol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/jth.13911","article-title":"Inflammation and thrombosis: roles of neutrophils, platelets and endothelial cells and their interactions in thrombus formation during sepsis","volume":"16","author":"T Iba","year":"2018","journal-title":"J Thromb Haemost"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1148\/radiol.12112236","article-title":"Natural course of extrahepatic nonmalignant partial portal vein thrombosis in patients with cirrhosis","volume":"265","author":"A Luca","year":"2012","journal-title":"Radiology"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.thromres.2016.02.024","article-title":"Survival after splanchnic vein thrombosis: A 20-year nationwide cohort study","volume":"141","author":"K K Sogaard","year":"2016","journal-title":"Thromb Res"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"2510","DOI":"10.1007\/s00268-011-1198-0","article-title":"Management of acute non-cirrhotic and non-malignant portal vein thrombosis: A systematic review","volume":"35","author":"T C Hall","year":"2011","journal-title":"World J Surg"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"6769","DOI":"10.3748\/wjg.v21.i22.6769","article-title":"Portal vein thrombosis in cirrhosis: Controversies and latest developments","volume":"21","author":"D J Harding","year":"2015","journal-title":"World J Gastroenterol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1161\/CIRCULATIONAHA.114.012871","article-title":"Mesenteric venous thrombosis","volume":"131","author":"C E Russell","year":"2015","journal-title":"Circulation"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jhep.2015.07.040","article-title":"EASL Clinical Practice Guidelines: Vascular diseases of the liver","volume":"64","author":"European Association for the Study of the Liver","year":"2016","journal-title":"J Hepatol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"14","DOI":"10.2214\/AJR.18.19548","article-title":"Portal vein thrombosis: Imaging the spectrum of disease with an emphasis on mri features","volume":"211","author":"R C Jha","year":"2018","journal-title":"Am J Roentgenol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1002\/hep.31646","article-title":"Vascular Liver Disorders, Portal Vein Thrombosis, and Procedural Bleeding in Patients With Liver Disease: 2020 Practice Guidance by the American Association for the Study of Liver Diseases","volume":"73","author":"P G Northup","year":"2021","journal-title":"Hepatology"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1002\/hep.23259","article-title":"Acute portal vein thrombosis unrelated to cirrhosis: A prospective multicenter follow-up study","volume":"51","author":"A Plessier","year":"2010","journal-title":"Hepatology"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.jceh.2014.12.008","article-title":"Portal vein thrombosis","volume":"5","author":"Y K Chawla","year":"2015","journal-title":"J Clin Exp Hepatol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.ejim.2014.12.002","article-title":"Anticoagulation for the treatment of portal vein thrombosis in liver cirrhosis: A systematic review and meta-analysis of observational studies","volume":"26","author":"X Qi","year":"2015","journal-title":"Eur J Intern Med"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1002\/hep.22772","article-title":"Vascular disorders of the liver","volume":"49","author":"L D DeLeve","year":"2009","journal-title":"Hepatology"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"4437","DOI":"10.3748\/wjg.v25.i31.4437","article-title":"Portal vein thrombosis in cirrhosis: Why a well-known complication is still matter of debate","volume":"25","author":"M Faccia","year":"2019","journal-title":"World J Gastroenterol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1053\/j.gastro.2017.04.042","article-title":"Effects of Anticoagulants in Patients With Cirrhosis and Portal Vein Thrombosis: A Systematic Review and Meta-analysis","volume":"153","author":"L Loffredo","year":"2017","journal-title":"Gastroenterology"},{"key":"ref19","first-page":"521","article-title":"Treatment responses and bleeding events associated with anticoagulant therapy of portal vein thrombosis in cirrhotic patients: systematic review and meta analysis","volume":"35","author":"B P Mohan","year":"2020","journal-title":"Ann Gastroenterol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1182\/bloodadvances.2019001310","article-title":"The efficacy and safety of direct oral anticoagulants in noncirrhotic portal vein thrombosis","volume":"4","author":"L Naymagon","year":"2020","journal-title":"Blood Adv"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1038\/s41424-018-0043-2","article-title":"Long-Term Outcome of Splanchnic Vein Thrombosis in Cirrhosis","volume":"9","author":"M Senzolo","year":"2018","journal-title":"Clin Transl Gastroenterol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1053\/j.gastro.2012.07.018","article-title":"Enoxaparin prevents portal vein thrombosis and liver decompensation in patients with advanced cirrhosis","volume":"143","author":"E Villa","year":"2012","journal-title":"Gastroenterology"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1097\/MEG.0000000000000351","article-title":"Efficacy and safety of anticoagulation therapy with different doses of enoxaparin for portal vein thrombosis in cirrhotic patients with hepatitis B","volume":"27","author":"S B Cui","year":"2015","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1016\/j.cgh.2012.01.012","article-title":"Efficacy and safety of anticoagulation on patients with cirrhosis and portal vein thrombosis","volume":"10","author":"M G Delgado","year":"2012","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jvsv.2016.05.003","article-title":"Mesenteric vein thrombosis can be safely treated with anticoagulation but is associated with significant sequelae of portal hypertension","volume":"4","author":"T S Maldonado","year":"2016","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1055\/a-0631-9265","article-title":"Interventional Treatment of Acute Portal Vein Thrombosis","volume":"190","author":"K Wolter","year":"2018","journal-title":"Rofo"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1097\/MEG.0000000000001559","article-title":"Escalating interventional recanalizaiton therapy in non-cirrhotic, non-malignant acute portal vein thrombosis","volume":"31","author":"M Gerwing","year":"2019","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1111\/apt.15811","article-title":"A prospective, multicentre study in acute non\u2010cirrhotic, non\u2010malignant portal vein thrombosis: comparison of medical and interventional treatment","volume":"52","author":"M Rossle","year":"2020","journal-title":"Aliment Pharmacol Ther"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.clinimag.2019.04.015","article-title":"Propensity-matched comparison of transjugular intrahepatic portosystemic shunt placement techniques: Intracardiac echocardiography (ICE) versus fluoroscopic guidance","volume":"57","author":"R S Ramaswamy","year":"2019","journal-title":"Clin Imaging"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1177\/1538574414547087","article-title":"Endovascular treatment of acute portal vein thrombosis using ultrasound-accelerated catheter-directed thrombolysis","volume":"48","author":"A K Abdel-Aal","year":"2014","journal-title":"Vasc Endovascular Surg"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1053\/tvir.2003.36433","article-title":"Applications of percutaneous mechanical thrombectomy in\u00a0transjugular intrahepatic portosystemic shunt and portal vein thrombosis","volume":"6","author":"R Uflacker","year":"2003","journal-title":"Tech Vasc Interv Radiol"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1007\/s12072-011-9324-5","article-title":"Transjugular intrahepatic portosystemic shunt in the treatment of portal vein thrombosis: A critical review of literature","volume":"6","author":"X Qi","year":"2012","journal-title":"Hepatol Int"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1053\/j.tvir.2016.01.006","article-title":"Portal Vein Recanalization and Transjugular Intrahepatic Portosystemic Shunt Creation for Chronic Portal Vein Thrombosis: Technical Considerations","volume":"19","author":"B Thornburg","year":"2016","journal-title":"Tech Vasc Interv Radiol"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1016\/j.jvir.2007.08.009","article-title":"Percutaneous transsplenic access in the management of bleeding varices from chronic portal vein thrombosis","volume":"18","author":"D J Tuite","year":"2007","journal-title":"J Vasc Interv Radiol"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1016\/j.jvir.2018.04.033","article-title":"Comparison of Bleeding Complications between Transplenic versus Transhepatic Access of the Portal Venous System","volume":"29","author":"M M Haddad","year":"2018","journal-title":"J Vasc Interv Radiol"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1016\/j.jvir.2019.02.003","article-title":"Percutaneous Transmesenteric Portal Vein Recanalization and Transjugular Direct Intrahepatic Portosystemic Shunt Creation for Chronic Portal Vein Occlusion","volume":"30","author":"K Farsad","year":"2019","journal-title":"J Vasc Interv Radiol"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1007\/BF02570190","article-title":"Transjugular intrahepatic portosystemic shunt after previous recanalization of a chronically thrombosed portal vein via a transmesenteric approach","volume":"19","author":"O Matsui","year":"1996","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.jvir.2014.12.012","article-title":"Portal vein recanalization\u2013transjugular intrahepatic portosystemic shunt using the transsplenic approach to achieve transplant candidacy in patients with chronic portal vein thrombosis","volume":"26","author":"A Habib","year":"2015","journal-title":"J Vasc Interv Radiol"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1016\/j.jvir.2017.08.005","article-title":"Pretransplantation portal vein recanalization and transjugular intrahepatic portosystemic shunt creation for chronic portal vein thrombosis: final analysis of a 61-patient cohort","volume":"28","author":"B Thornburg","year":"2017","journal-title":"J\u00a0Vasc Interv Radiol"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/apt.15044","article-title":"Systematic review with meta-analysis: portal vein recanalisation and transjugular intrahepatic portosystemic shunt for portal vein thrombosis","volume":"49","author":"S G Rodrigues","year":"2019","journal-title":"Aliment Pharmacol Ther"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1097\/MEG.0000000000001219","article-title":"The role of transjugular intrahepatic portosystemic shunt in the management of portal vein thrombosis: a systematic review and meta-analysis","volume":"30","author":"N Valentin","year":"2018","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/j.dld.2017.05.020","article-title":"Transjugular local thrombolysis with\/without TIPS in patients with acute non-cirrhotic, non-malignant portal vein thrombosis","volume":"49","author":"C Klinger","year":"2017","journal-title":"Dig Liver Dis"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1007\/s00270-004-0241-z","article-title":"Transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of venous symptomatic chronic portal thrombosis in non-cirrhotic patients","volume":"27","author":"J I Bilbao","year":"2004","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.hbpd.2020.12.016","article-title":"Transjugular intrahepatic portosystemic shunt is effective in patients with chronic portal vein thrombosis and variceal bleeding","volume":"20","author":"X Y Sun","year":"2021","journal-title":"Hepatobiliary Pancreat Dis Int"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1055\/s-0043-121348","article-title":"Transjugular portal vein recanalization with creation of intrahepatic portosystemic shunt (PVR-TIPS) in patients with chronic non-cirrhotic, non-malignant portal vein thrombosis","volume":"56","author":"C Klinger","year":"2018","journal-title":"Z Gastroenterol"},{"key":"ref46","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s00068-016-0634-0","article-title":"ESTES guidelines: acute mesenteric ischaemia","volume":"42","author":"J VT Tilsed","year":"2016","journal-title":"Eur J Trauma Emerg Surg"},{"key":"ref47","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1097\/01.RVI.0000156265.79960.86","article-title":"Transcatheter thrombolytic therapy for acute mesenteric and portal vein thrombosis","volume":"16","author":"M Hollingshead","year":"2005","journal-title":"J Vasc Interv Radiol"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-020-04624-4","article-title":"Systematic Review of Thrombolysis Therapy in the Management of Non-Cirrhosis-Related Portal Vein Thrombosis","author":"Q Cheng","year":"2021","journal-title":"J\u00a0Gastrointest Surg"},{"key":"ref49","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1111\/apt.15479","article-title":"A stepwise thrombolysis regimen in the management of acute portal vein thrombosis in patients with evidence of intestinal ischaemia","volume":"50","author":"A Benmassaoud","year":"2019","journal-title":"Aliment Pharmacol Ther"},{"key":"ref50","doi-asserted-by":"crossref","first-page":"334","DOI":"10.4174\/astr.2014.86.6.334","article-title":"Mechanical thrombectomy-assisted thrombolysis for acute symptomatic portal and superior mesenteric venous thrombosis","volume":"86","author":"K W Jun","year":"2014","journal-title":"Ann Surg Treat Res"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1177\/0284185117742683","article-title":"Treatment of acute portomesenteric venous thrombosis with thrombectomy through a transjugular intrahepatic portosystemic shunt: a single-center experience","volume":"59","author":"K Rosenqvist","year":"2018","journal-title":"Acta Radiol"},{"key":"ref52","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/01.RVI.0000188573.22070.0D","article-title":"Vascular injury caused by mechanical thrombectomy in porcine arteries: AK\u00f3nya eliminator device versus Arrow-Trerotola percutaneous thrombolytic device","volume":"17","author":"A K\u00f3nya","year":"2006","journal-title":"J Vasc Interv Radiol"},{"key":"ref53","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1148\/radiology.219.1.r01ap36153","article-title":"Comparison of three mechanical thrombus removal devices in thrombosed canine iliac arteries","volume":"219","author":"F Casta\u00f1eda","year":"2001","journal-title":"Radiology"},{"key":"ref54","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1007\/s00270-007-9137-z","article-title":"Transjugular intrahepatic portosystemic shunt, mechanical aspiration thrombectomy, and direct thrombolysis in the treatment of acute portal and superior mesenteric vein thrombosis","volume":"30","author":"C Ferro","year":"2007","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref55","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1007\/s00270-014-0896-z","article-title":"Acute superior mesenteric venous thrombosis: transcatheter thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery in eight patients","volume":"38","author":"S Yang","year":"2015","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref56","first-page":"20180024","article-title":"Successful recanalization of acute extensive portal vein thrombosis by aspiration thrombectomy and thrombolysis via an operatively placed mesenteric catheter: a case report","volume":"4","author":"N Kennoki","year":"2018","journal-title":"BJR Case Rep"},{"key":"ref57","first-page":"58","volume-title":"Thrombectomy devices","author":"S Zangan","year":"2014","edition":"2nd ed."}],"container-title":["R\u00f6Fo - Fortschritte auf dem Gebiet der R\u00f6ntgenstrahlen und der bildgebenden Verfahren"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1642-0990.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T00:29:58Z","timestamp":1643243398000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1642-0990"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,14]]},"references-count":57,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2022,1,26]]},"published-print":{"date-parts":[[2022,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1642-0990","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1438-9029","1438-9010"],"issn-type":[{"value":"1438-9029","type":"print"},{"value":"1438-9010","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,14]]}}}