Intra-abdominal Venous Thromboses and Their Management

Area of Science:

• Vascular Medicine
• Interventional Radiology
• Gastroenterology

Background:

• Deep venous thromboses (DVT) literature predominantly focuses on extremities.
• Intra-abdominal venous thromboses (IAVT) encompass diverse conditions like 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 IAVT presents distinct microenvironmental management challenges.

Purpose of the Study:

• To provide a comprehensive review of intra-abdominal venous thromboses.
• To detail the pathophysiology, clinical features, and imaging findings of various IAVTs.
• To outline current and emerging management strategies for IAVTs.

Main Methods:

• Literature review focusing on intra-abdominal venous thromboses.
• Analysis of diagnostic modalities including Doppler ultrasound, CT, and MRI.
• Evaluation of treatment outcomes for systemic anticoagulation, catheter-directed thrombolysis, thrombectomy, and transjugular intrahepatic portosystemic shunt (TIPS) creation.

Main Results:

• Doppler ultrasound is the primary diagnostic tool, with CT and MRI aiding in thrombus burden assessment and interventional planning.
• Systemic anticoagulation is standard medical therapy.
• Catheter-directed thrombolysis and thrombectomy demonstrate positive outcomes for ICVO, HVT, PVT, and RVT.
• TIPS creation is particularly beneficial for HVT and PVT.

Conclusions:

• Intra-abdominal venous thromboses require specialized management approaches.
• Advanced interventional techniques offer effective treatment options beyond systemic anticoagulation.
• Further research into IAVT pathophysiology and treatment optimization is warranted.