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CHALLENGING CASES A Combination Approach to Mesenteric Venous Thrombosis Using percutaneous transhepatic thrombectomy and pharmacological thrombolysis to treat this highly morbid condition. BY WEI ZHOU, MD; TAM T. HUYNH, MD; AND PETER H. LIN, MD M esenteric venous thrombosis (MVT) is an uncommon condition associated with significant mortality and morbidity, due in part to nonspecific presentations and frequent delays in diagnosis. The traditional management has been medical treatment with anticoagulation. Surgery is reserved for patients who have failed medical therapy or who present with signs of mesenteric ischemia. Endovascular intervention utilizing percutaneous mechanical thrombectomy (PMT) and thrombolysis provides an attractive alternative that is less invasive with minimal complications. We describe a patient with symptomatic MVT who was successfully treated with a percutaneous transhepatic approach. Several endovascular techniques were utilized to achieve the optimal result. protein C and S, homocysteine, factor V Leiden, antithrombin, prothrombin mutation 20210, fibrinogen, lupus anticoagulant, and anticardiolipin antibody did not reveal any abnormality. Due to her ac ...
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