Needed: New Treatment Options for Portal Vein Thrombosis (PVT)

by Clint on September 24, 2010

Balloon-catherter While at my family doctor’s office a few days ago, we were discussing the forthcoming appointment I have next month with my gastroenterologist.  My gastroenterologist, Dr. Puneeta Tandon has just returned to the University of Alberta Hospital here in Edmonton, after a year of specialized study in the area of Portal Hypertension.  Dr. Tandon studied  in Barcelona Spain for the first 6 months, and for the remainder of that year  worked with  Dr. Guadalupe Garcia-Tsao at Yale University in New Haven,  Connecticut.  Dr. Tandon heads up western Canada’s only Portal Hypertension clinic.  I mentioned to my family doctor that I had many questions for Dr. Tandon, and he himself wanted me to ask her if doctor’s had ever considered performing a balloon angioplasty to remove a clot to the portal vein. A great question for sure!   My doctor reminded me of the recent treatment on MS patients called the Liberation Treatment.

Rather than trying to explain the treatment I have copied a link below  from a CTV program called W5 which covers the whole topic in greater detail.  Along with other questions I personally have for Dr. Tandon, I welcome any questions you may have regarding  portal hypertension.  My appointment is in mid-October (2010) so if you are wondering about any new possible treatment options or require a better understanding of the condition send me a message and I will gladly add it to my list and post the answers after the fact.

Until next time,

Clint

Click here to view the CTV program:  http://www.ctv.ca/CTVNews/WFive/20091120/W5_liberation_091121/

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{ 8 comments… read them below or add one }

fozia saleem December 28, 2011 at 8:07 pm

coarse hepatic parenchymal echotexture without any focal lesion or biliary dilataion.portal vein could not be identified confidently and is most likely thrombosed as there is evidence of canvernous transformation.spleen is also significantly enlarged with diffuse punctate calcific foci and multipul varices at its hilum.spleen measures 189mm.there is no ascites.galbladder is contrated pancreas is unremarkable.both kidneys have normal parenchyma without any evidence of calculus,cyst or hydronephrosis CONCLUSION: chronic liver disease with portal vein thrombosis and carvanious transformation along with splenomegaly and abdominal varices hey i fozia from pakistan my sister is suffering portal hypertension with portal vein thrombosis and its the recent ultrasond report of abdomin plz help us in this situation .um much worried about her health but have no idea what should we do?

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Clint December 30, 2011 at 3:31 am

Fozia … so sorry to learn about your sister’s condition. It is a complicated disconcerting disease, and when one first learn’s about portal hypertension – it can be very frightening for sure. Have doctor’s prescribed a beta blocker to keep her blood pressure down? A beta blocker such as Nadolol helps to lower pressure in the event that one or more varices could bleed possibly bleed and complicate her situation even further. Another standard treatment used for the condition is the prescribing of an acid reducer such as Panteloc. An acid reducer is used to prevent stomach acid from wearing down the varices and causing them to bleed. It also seems to be common for doctors to prescribe a blood thinner, but that is something you may want to look into further because it would all depends on the person and what their complications may be. As far as medical procedures is, it is all dependent on the person’s individual country and what they are capable of doing as far as intervention is concerned. A specialist (gastroenterologist) would be the best person to speak with regarding all of this. To date I have no information regarding doctor’s in Asia, or Africa, but can only refer to a hospital in the UK, some specialists in the US, or maybe here in Canada? I hope this is helpful? Praying for your sister, you, and the rest of your family as you come to terms with this condition.

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kalai April 17, 2012 at 5:36 am

hi
my baby she is 8 month suffering from portal vein thrombosis. is there any way to clear the clot

kalai

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Nida April 18, 2012 at 2:43 pm

Hello
My father is suffering from HCC and portal vein thrombosis. He has varices on spleenic hilum as well. I read that varices can develop on esophagus as well as on intestines and that they bleed heavily. I am from Pakistan. I don’t know if any treatment for portal vein thrombosis is available in my country. my father’s doctor said that there is no treatment. Please suggest some option. My father is 64 years old. He underwent TACE as well and only after TACE did he develope PVT (CT scan didn’t show PVT prior to TACE). Can endoscopy be performed to remove this clot?

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Clint April 20, 2012 at 9:12 am

Hi Nida,

I am so sorry to hear about your father’s condition. Unfortunately there is no operation to date to clear the clot in that area. I have only heard of clot’s dissolving in rare cases, but that is usually in acute stages – according to my gastroenterologist. Yes, varices can develop on the esophogas (I have them), and the standard treatment (worldwide) is to lower the heart rate by using a beta blocker such as Nadolol. If varices develop and they bleed doctors will try to stop the bleeding using a baloon tamponade, expanding that in the esophogas and in turn try to keep the airway open. If varices are discovered there, they will sometimes band them in order to prevent future bleeds. Unfortunately you are right in saying they can bleed heavily, and if this occurs then it is important you get your father to a medical facility as soon as possible. If he bleeds from varices that can occur in the stomach, and his stool is black – this is also treated as am emergency even though he may not experience a great amount of pain. Can you tell me what a TACE and HCC is – I know these are shortened words for a particular procedure, but I am not sure what that may be?

As do all the people who write on my blog – I will pray for your father. I know I may not have been positive in my response above, but you need to be aware of what could happen. If is is any consulation to you I have had portal hypertension for 10 years now, and have only experienced 1 bleed and that occured because of varices in my stomach.

Kindest regards, Clint

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Nida April 19, 2012 at 2:54 pm

Kindly respond!
My father’s doctor has prescribed him nothing for PVT. What is your suggestion regarding beta blockers?? And what could be the possible side effects?? Doctor said anti coagulants won’t work. He had moderate ascites as well the last time he went for ultrasound. Doctor prescribed aldactone.He is soon going to have next ultrsound. I think that either his ascites has reduced or his liver is deteriorating. Last ultrasound report said normal liver size with 5 leisions. My father doesn’t feel any pain or he does once or twice in a week. Please help out. he is loosing his health. He has become more weak for the last two weeks. Should we ask his doctor about beta blocker for varices?
respond as soon as you can

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Clint April 20, 2012 at 9:16 am

I responded to your first message regarding beta blockers and hopefully this will help answer your questions. The only thing I can add about beta blockers is that they can make one feel very tired because they will slow the heart rate down in order to prevent bleeding from any varices. If he has varices – yes he needs to be on a beta blocker and monitored accordingly. Hope this helps?

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Nida April 22, 2012 at 2:18 pm

Thanks a lot for replying.
You asked about HCC and TACE. HCC is Hepatocellular Carcinoma and TACE stands for TransArterial Chemoembolization.
Thanks once again, your reply was really informative and yes please do keep praying for my father.

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