Related Experiment Video
Updated: Nov 18, 2025

New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation
Published on: June 27, 2025
Ruptured idiopathic hepatic artery pseudoaneurysm causing portal vein thrombosis with portal hypertension and
Kevin Ni1, Claire Jansson-Knodell2, Matthew E Krosin1
1Division of Interventional Radiology, Department of Radiology & Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd Room 0663, Indianapolis, IN 46202, USA.
Abstract:
Portal vein thrombosis (PVT) is an important cause of noncirrhotic portal hypertension. Noncancerous extrinsic compression of portal vein to drive PVT formation is rare, but important to identify. A 64-year-old female with idiopathic hepatic artery pseudoaneurysm (HAPA) rupture 7 months prior presented with acute-onset hematemesis and melena and was found to have prehepatic portal hypertensive variceal bleeding. Her HAPA-related retroperitoneal hematoma had resulted in portal vein compression, thrombosis, and cavernous transformation despite prompt stent graft placement across the ruptured HAPA, and required definitive treatment by transjugular intrahepatic portosystemic shunt creation with portal vein reconstruction utilizing a trans-splenic access. This case highlights the importance of interval abdominal imaging and hypercoagulability screening for noncirrhotic patients at-risk for PVT, which identified the patient as a heterozygous carrier of Factor V Leiden.
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