Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Portal Vein Thrombosis
Question: Are there any options for opening or treating portal vein thrombosis when the vein is blocked with cancerous tumor? 78 year old father with stage 3 hepatoma, 6.8 cm tumor in right lobe, and portal vein thrombosis believed to be caused by tumor.
Brief Answer:
Radio-embolization can be tried. It is for the Hepatoma.
Detailed Answer:
Hello.
Welcome to HealthcareMagic and Thanks for the question.
Portal vein thrombosis usually itself not so problematic. The problems occur due to its after effects due to increased back pressure on the portal circulation called Portal Hypertension and also because it provides 75% of blood supply and nutrients to the liver. Therefore it is definitely not a good thing.
It is usually treated by Heparin injections which usually help to clear it off.
We can mechanically also attempt to remove the thrombus, but since it is due to cancer it is unlikely to help as the tumor is sitting there and the thrombosis will definitely re occur even after removal.
Until the tumor is treated, there is no real point in treating the thrombosis.
But Heparin injections(LMWH - 60mg subcutaneously twice a day should help clear it).
Radioembolization is being suggested for the Hepatoma and not for the thrombosis. That would be actually the right approach according to me. If that works then the thrombosis also might resolve.
Take care and do let me know if there are other queries on this issue.
Dr Rishi, New XXXXXXX XXXXXXX
Radio-embolization can be tried. It is for the Hepatoma.
Detailed Answer:
Hello.
Welcome to HealthcareMagic and Thanks for the question.
Portal vein thrombosis usually itself not so problematic. The problems occur due to its after effects due to increased back pressure on the portal circulation called Portal Hypertension and also because it provides 75% of blood supply and nutrients to the liver. Therefore it is definitely not a good thing.
It is usually treated by Heparin injections which usually help to clear it off.
We can mechanically also attempt to remove the thrombus, but since it is due to cancer it is unlikely to help as the tumor is sitting there and the thrombosis will definitely re occur even after removal.
Until the tumor is treated, there is no real point in treating the thrombosis.
But Heparin injections(LMWH - 60mg subcutaneously twice a day should help clear it).
Radioembolization is being suggested for the Hepatoma and not for the thrombosis. That would be actually the right approach according to me. If that works then the thrombosis also might resolve.
Take care and do let me know if there are other queries on this issue.
Dr Rishi, New XXXXXXX XXXXXXX
Above answer was peer-reviewed by :
Dr. Remy Koshy
Currently he has good liver function and a "grade A" liver, even with the tumor and thrombosis. Will the thrombosis reduce the liver function and shorten his life expectancy? Also, he currently has no bloating and very little pain (randomly, not constantly). Will the thrombosis change this? What specifically is "mechanically remove the thrombosis"-so I can research. Thank you!
Brief Answer:
Tumor should be dealt with first.
Detailed Answer:
Hello,
Thanks for your reply.
I am a Vascular Surgeon practicing in XXXXXXX
The thrombosis can lead to a decrease in liver function due to decrease in supply of good blood to the liver.
Bloating and pain cant be predicted upon but it is likely that slowly they might increase and this might shorten the life expectancy.
At our Center, we remove Thrombus from many veins by Thromboaspiration, Thrombolysis, etc. But these things work only if the thrombus is fresh. And it has rarely been tried in the Portal vein. Therefore very little experience with that area.
But you can research and might get some Interventiional Radiologist to help you. But it will be futile till the tumor has been treated.
Take care and do let me know if I can be of further assistance.
Would be happy to help.
Dr Rishi, New XXXXXXX XXXXXXX
Tumor should be dealt with first.
Detailed Answer:
Hello,
Thanks for your reply.
I am a Vascular Surgeon practicing in XXXXXXX
The thrombosis can lead to a decrease in liver function due to decrease in supply of good blood to the liver.
Bloating and pain cant be predicted upon but it is likely that slowly they might increase and this might shorten the life expectancy.
At our Center, we remove Thrombus from many veins by Thromboaspiration, Thrombolysis, etc. But these things work only if the thrombus is fresh. And it has rarely been tried in the Portal vein. Therefore very little experience with that area.
But you can research and might get some Interventiional Radiologist to help you. But it will be futile till the tumor has been treated.
Take care and do let me know if I can be of further assistance.
Would be happy to help.
Dr Rishi, New XXXXXXX XXXXXXX
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
