Intra-abdominal Venous Thromboses and Their Management.

Jan 08, 2024

Experts: Karan Rao,Yashant Aswani,Hans Bindner,Aditi Patel,Sarah Averill,Trent Davis,Mohammad Amarneh

While a plethora of articles discuss management of deep venous thromboses in extremities, there is a relative scarcity of literature comprehensively describing intra-abdominal venous thromboses, and their management. Intra-abdominal venous thromboses include iliocaval venous obstruction (ICVO), hepatic venous thrombosis (HVT), portal venous thrombosis (PVT), renal vein thrombosis (RVT), splenic vein thrombosis (SVT), and gonadal vein thrombosis (GVT); each of which provides unique microenvironmental challenges to management. Doppler ultrasound is the first line imaging modality for diagnosis, and computed tomography and magnetic resonance imaging can help define the extent of thrombus burden and aid with interventional planning. Systemic anticoagulation remains the common medical treatment for intra-abdominal venous thrombosis, however, catheter directed thrombolysis and thrombectomy show positive outcomes in ICVO, HVT, PVT, and RVT, with transjugular intrahepatic portosystemic shunt (TIPS) creation especially beneficial in HVT and PVT. In this review article, we describe pathophysiology, clinical features, imaging findings, and current management options for intra-abdominal venous thromboses.
Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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ABOUT THE EXPERTS

Karan Rao,Yashant Aswani,Hans Bindner,Aditi Patel,Sarah Averill,Trent Davis,Mohammad Amarneh

Karan Rao

Department of Vascular and Interventional Radiology, University of Iowa, lowa city, lowa, USA (K.R., Y.A., H.B., A.P.).

Yashant Aswani

Department of Vascular and Interventional Radiology, University of Iowa, lowa city, lowa, USA (K.R., Y.A., H.B., A.P.).

Hans Bindner

Department of Vascular and Interventional Radiology, University of Iowa, lowa city, lowa, USA (K.R., Y.A., H.B., A.P.).

Aditi Patel

Department of Vascular and Interventional Radiology, University of Iowa, lowa city, lowa, USA (K.R., Y.A., H.B., A.P.).

Sarah Averill

Roswell Park Comprehensive Cancer Institute, Buffalo, New York, USA (S.A.).

Trent Davis

Dignity Health St. Joseph’s Radiology, Phoenix, Arizona, USA (T.D.).

Mohammad Amarneh

Department of Pediatric Interventional Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, Massachusetts 02115, USA (M.A.). Electronic address: Mohammad.Amarneh@childrens.harvard.edu.