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

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/

21 thoughts on “Needed: New Treatment Options for Portal Vein Thrombosis (PVT)

  1. Humayun Mughal

    Dear Clint

    My mother is suffering from Hepatocellular carcinoma with PVT. Key to her treatment is removal of PVT. Can you suggest any hospital or a specialist who can help us. We are willing to take her to any part of the world.

    Reply
    1. Clint Post author

      Hello,

      Thanks for your response. I am sorry to hear of your mother’s illness. What part of the world do you live in? If you indicate where you live I possibly can suggest a few doctor’s and/or medical centres you may want to contact.

      You say “key” to her treatment is the removal of PVT, but unfortunately to date there is no operation that will remove this clot from the portal vein, however there is a bypass operation called the TIPS procedure that doctor’s may possibly perform to aleviate the symptoms of PVT. The side effects of portal hypertension are varied but the most common is bleeding from varices which form in the esophogas over time from the clot in the Portal Vein itself.

      The Rex Shunt procedure is another operation that has proven to be successful but only on younger children with Portal Hypertension. The few attempts that have been made on adults have been fatal, because the condition of the portal vein deteriorates the older one gets. I know this is not something no one really wants to hear, but there are many people like myself who would love to have an option such as this. The standard treatment protocol in the world seems to be the utilization of beta blockers to slow the heart rate in order to keep the varices from rupturing within the esophogas. There are also other common drugs used in the management and prevention of complications due to Portal Hypertension.

      Hope this helps?

      Reply
  2. Alice

    hi :
    I have a good friend that have Portal Venous Trombosis, she is in lima Peru. Do you know some hospital that can treat her. She is only with anticoagulantes they dint find anything else that cause the PVT. If you can tell me speciality hospital for this disease a really appreciated.

    Reply
    1. Clint Post author

      Hello Alice,

      I am sorry but off hand I do not have information regarding a speciality hospital in Peru that may treat PVT. Most gastroenterologists would be familiar with Portal Vein Thrombosis, and they are the best people to consult with regarding such. I managed to find a link with 4 gastroenterologists in Peru who may be able to help you with your friend’s condition. I would say to just contact anyone of them and they should be able to direct you accordingly.

      http://archive.livinginperu.com/dir/health-medical/gastroenterology

      Sincere best for your friend – I hope and pray you find the answers you require right now.

      Clint

      Reply
  3. Papa dasari

    I am to treat a pregnant woman at term with portal vein thrombosis/spleenic vein thrombosis. How do I go about ?
    thanks
    Obstetrician

    Reply
    1. Clint Post author

      I am sorry I am unable to help you as I am not a doctor. A gastroenterologist would be the best person to contact regarding this type of surgery. You may want to check within your respective country, or I can possibly give you a name and hospital to contact.

      Reply
  4. Samantha

    Hi, i’m from Brazil and my mother-in-low is suffering a lot because SINCE last year doctors could see that her portain vein is almost completaly damaged. So they sad that she has portal vein trombosis.Then her liver is almost stopping right now and we don’t know what we can do. First we supposed to find a way to “fix’ that vein using some kind of new tecnology for that like the balloon angioplasty.After that she needs another liver. So could you help me? I don’t know, with some doctor’s names, countries, important hospitals, because the stuff from the hospital that she is treating now just sad that is IMPOSSIBLE to help her, like she is dieing and it’s impossible to revert this situation. Sorry about my poor english, but i holp that you will hel all of us.THanks very much.

    Reply
    1. Clint Post author

      Hello Samantha,

      Sorry about your your mother-in-law’s current health condition. I have not heard of any kind of new technology like a balloon angioplasty to fix the portal vein. As far as I know the portal vein can’t be entered but only bypassed. I also do not know of any doctors in South America who are treating Portal Hypertension, and I am hoping that someone may recommend someone soon for that part of the world. In the meantime I am going to recommend you contact Dr. Jean Emond in New York as I understand he might have either a contact for you or at least have some ideas. I live in Canada so I am even further from where you live, so that is why I am suggesting you get in touch with him. Here is the link for his site in which you may find his contact information:

      http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=je111&DepAffil=Surgery

      If you are unable to get ahold of him for any reason, I have more contacts for you to try. Please let me know what you find out.

      Sincerely,

      Clint

      Reply
  5. Keith F

    Aloha Clint,
    I live in Hawaii and am only 38. I just got diagnosed with PVT the right is fully blocked and the left is partial. The doctors out here don’t see many cases like this. Liver is healthy they can not seem to find why I have this I don’t have any varisies (veins) in esophagus yet so no major bleeding, but my spleen is enlarged. They don’t know why I have this, I think it is from a hard fall while surfing eight weeks ago. Hit the board hard in the liver region. They put me on blood thinners but have read that may not be the best course sometimes. Do you know of the success rates of thinners? Do you know of any specialty clinics or doctors like Dr.Emond on the West Coast of the United States? By the way how did the balloon angioplasty research pan out. Has it been done successfully? I am an athlete in need of answers any names or numbers or links to info would be helpful.

    Reply
    1. Clint Post author

      Hello Keith,

      Hawaii … have not been there yet, but my parents lived there in 1956 for short time but unfortunately that was before I was born. I often have thought that it would have been really cool to have been born there! We only have some old “techicolor” slides of the time they lived there, and my two oldest brothers were too small to remember anything.

      I am always sorry to learn of people with the diagnosis of PVT as it is most disconcerting. Common to PVT patients is the spleen being clotted due to the location of the clot near the liver. Like you my liver is healthy, and the cause for my clotting disorder is said to be an unknown genetic cause. I don’t know where you read that thinners was not the best course, but you have to remember you have a clot and they need to prevent further clotting – anywhere. Thinners themselves do not clear a PVT clot according to all that I have learned over the years, but the rear danger is the development of varices which unfortunately can take place over time because the blood is being re-routed to smaller arteries which are not designed to handle this type of volume. The arteries on the lining of your esophogas and the upper part of your stomach, may eventually succomb to pressure and therefore create varices so you want to stay on the thinners and get doctors to scope you occasionally to evaluate whether or not they are there and what condition they may be in. The good thing about you is your liver is in good shape, and I think it is helpful overall.

      Off hand I do not know of doctor I can refer you to specifically on the west coast, but I would give Dr. Emond a call anyways as he or his staff might direct you accordingly. You may also want to contact the Digestive Disease Center at UCLA Medical Center in Los Angeles. Being a Canadian I know that UCLA is very renowned and is one of the best hospitals in the US, besides the Mayo Clinics and a few other centers. Here is the link with the information for the Gastroenterology division: http://gastro.ucla.edu/

      Dr. Emond’s contact information in New York: http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=je111&DepAffil=Surgery

      You could also contact Dr. Riccardo Superina’s office at Children’s Memorial Hospital in Chicago as he may also have options for you. Dr. Superina has offered to preview my imaging for a second opinion, and has previewed imaging for a few of the people I have come to know through this blog. You can reach his office through this link: http://www.childrensmemorial.org/findadoc/bios.aspx?id=993

      I never did find out how the balloon angioplasty research went but will see if I can hunt down some answers for you.

      Well I hope you get some answers? Please let me know if you have any further questions or concerns and I will do my best to help you get the answers you need.

      Take care,
      Clint

      Reply
  6. Keith F.

    Hey Clint thanks for the feed back on this post. I have been doing some intense reading. I have found that Thrombolsis (spelling?) is an option to knock out the clot. The say it is from a bacteria that goes in and breaks down the infrastucture of the clot. What do you know about this?

    I also found that angioplasty is a very common treatment for post liver transplant clots. so if they can do this for that therapy why can’t it be done for just a clot. Could you check with Dr.Tandon or post her info so I can.

    I am on warfrin and am hoping the thinning of the blood will allow my bodies own natural process to remove the clot. I read some where online that I have 50-80% chance that this will happen. I just need to wait 8 weeks to see if there is any breakdown even if there is a litttle then my body is doing me a favor.
    For me they are still wondering why I got it.

    Do you know of any good foods that might help break down clots?

    The varices are a scary thing and like I mentioned I don’t have any yet. Do you know how long it takes for them to develop? Being that my main vein is clear, the right is blocked, the left is only partial blocked there is still flow. Would I still back up that much pressure to create varicies. One of my doctors says yes the other says no and to go surf and don’t worry. I really need to find some doctor who knows. Both of mine said this is very rare for them to see. Any info or advice is appreciated.

    I will check with the doctors you mentioned above to see if they can help in any way.

    thanks keith
    Thanks for the communication.

    Reply
  7. Samantha

    Thanks very much for your attention,my mother-in-law still bad, actually worse right now. However.i’m going to try to contact this doctor that you indicated. Maybe he may say some names here in Brazil. I live in São Paulo, a huge city. Why not to try?!?

    God bless You

    Thanks….

    Reply
    1. Clint Post author

      Samantha … I hope and pray that you find someone to treat your mother-in-law in your country. Although portal hypertension is rare, there should be doctor’s in your part of the world that know something about this condition and can treat her accordingly.
      Blessings to you and your mother-in-law this Christmas. Please keep me/us posted on what you find out?

      Reply

Leave a Reply

Your email address will not be published. Required fields are marked *