To TIPS or not to TIPS? More than ever, younger patients are presenting with acute portal vein thrombosis (PVT) that requires intervention beyond anticoagulation alone. These patients need safe, effective options that offer long-term resolution and a good quality of life after treatment. In this episode of the BackTable Podcast, Dr. Benjamin May, Interventional Radiologist at Weill Cornell Medicine, discusses the evolving treatment landscape for acute PVT.
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SYNPOSIS
Dr. May shares insights into the changing interventional approaches, highlights the utility of tools such as suction thrombectomy devices, and explains how his best practices have developed over time. He emphasizes the continued importance of anticoagulation therapy, explores the potential complications and outcomes of various interventions, and discusses how thrombus location and characteristics influence his clinical decisions. With real-world scenarios and a step-by-step walkthrough of his decision-making process, Dr. May offers a comprehensive look at modern strategies for managing acute portal vein thrombosis.
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TIMESTAMPS
00:00 - Introduction
05:46 - Diagnosing Portal Vein Thrombosis
10:52 - Management Options for Acute PVT and What is Safest?
21:09 - Choosing an Intervention Approach
26:19 - Tackling Large Bore Thrombectomy
32:37 - Learnings and Tips for Successful Thrombectomy
39:50 - Impact of Thrombus Location on Intervention Approach
45:01 - Post-Care and Follow-Up
49:46 - Final Thoughts and Encouragement
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RESOURCES
“Transjugular Intrahepatic Portosystemic Shunt and Thrombectomy (TIPS-Thrombectomy) for Symptomatic Acute Noncirrhotic Portal Vein Thrombosis” (Shalvoy, 2023)
https://www.jvir.org/article/S1051-0443(23)00341-X/abstract