An unconventional therapeutic approach for a severe case of septic pylephlebitis involving the portal system using pharmacomechanical thrombolysis and thrombectomy

Pylephlebitis has a high risk of mortality. Even with optimal medical management, the thrombus may propagate and require intervention. We present one such case in which extension of the thrombus from the superior mesenteric vein to the intrahepatic portal veins led to a life-threatening systemic res...

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Main Authors:	Richard Ricca, MD, FACS, Rachel Grinnan, DO, Joseph Brandt, DO
Format:	Article
Language:	English
Published:	Elsevier 2020-06-01
Series:	Journal of Vascular Surgery Cases and Innovative Techniques
Subjects:	Pylephlebitis Pharmacomechanical thrombolysis Thrombectomy
Online Access:	http://www.sciencedirect.com/science/article/pii/S2468428720300460

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spelling	doaj-278befb241ad4c03b6a607127b0539f92020-11-25T03:46:46ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872020-06-0162262265An unconventional therapeutic approach for a severe case of septic pylephlebitis involving the portal system using pharmacomechanical thrombolysis and thrombectomyRichard Ricca, MD, FACS0Rachel Grinnan, DO1Joseph Brandt, DO2Correspondence: Richard Ricca, MD, FACS, Department of Surgery, Stony Brook Southampton Hospital, 240 Meeting House Ln, Southampton, NY 11968; Department of Surgery, Stony Brook Southampton Hospital, Southampton, NYDepartment of Surgery, Stony Brook Southampton Hospital, Southampton, NYDepartment of Surgery, Stony Brook Southampton Hospital, Southampton, NYPylephlebitis has a high risk of mortality. Even with optimal medical management, the thrombus may propagate and require intervention. We present one such case in which extension of the thrombus from the superior mesenteric vein to the intrahepatic portal veins led to a life-threatening systemic response. Current endovascular techniques tailored with targeted pharmacomechanical thrombolytic therapy were combined with an exploratory laparotomy for septic control and resulted in an accelerated recovery.http://www.sciencedirect.com/science/article/pii/S2468428720300460PylephlebitisPharmacomechanical thrombolysisThrombectomy
collection	DOAJ
language	English
format	Article
sources	DOAJ
author	Richard Ricca, MD, FACS Rachel Grinnan, DO Joseph Brandt, DO
spellingShingle	Richard Ricca, MD, FACS Rachel Grinnan, DO Joseph Brandt, DO An unconventional therapeutic approach for a severe case of septic pylephlebitis involving the portal system using pharmacomechanical thrombolysis and thrombectomy Journal of Vascular Surgery Cases and Innovative Techniques Pylephlebitis Pharmacomechanical thrombolysis Thrombectomy
author_facet	Richard Ricca, MD, FACS Rachel Grinnan, DO Joseph Brandt, DO
author_sort	Richard Ricca, MD, FACS
title	An unconventional therapeutic approach for a severe case of septic pylephlebitis involving the portal system using pharmacomechanical thrombolysis and thrombectomy
title_short	An unconventional therapeutic approach for a severe case of septic pylephlebitis involving the portal system using pharmacomechanical thrombolysis and thrombectomy
title_full	An unconventional therapeutic approach for a severe case of septic pylephlebitis involving the portal system using pharmacomechanical thrombolysis and thrombectomy
title_fullStr	An unconventional therapeutic approach for a severe case of septic pylephlebitis involving the portal system using pharmacomechanical thrombolysis and thrombectomy
title_full_unstemmed	An unconventional therapeutic approach for a severe case of septic pylephlebitis involving the portal system using pharmacomechanical thrombolysis and thrombectomy
title_sort	unconventional therapeutic approach for a severe case of septic pylephlebitis involving the portal system using pharmacomechanical thrombolysis and thrombectomy
publisher	Elsevier
series	Journal of Vascular Surgery Cases and Innovative Techniques
issn	2468-4287
publishDate	2020-06-01
description	Pylephlebitis has a high risk of mortality. Even with optimal medical management, the thrombus may propagate and require intervention. We present one such case in which extension of the thrombus from the superior mesenteric vein to the intrahepatic portal veins led to a life-threatening systemic response. Current endovascular techniques tailored with targeted pharmacomechanical thrombolytic therapy were combined with an exploratory laparotomy for septic control and resulted in an accelerated recovery.
topic	Pylephlebitis Pharmacomechanical thrombolysis Thrombectomy
url	http://www.sciencedirect.com/science/article/pii/S2468428720300460
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An unconventional therapeutic approach for a severe case of septic pylephlebitis involving the portal system using pharmacomechanical thrombolysis and thrombectomy

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