Assuntos
Embucrilato/efeitos adversos , Úlcera Péptica Hemorrágica/terapia , Escleroterapia/efeitos adversos , Adesivos Teciduais/efeitos adversos , Fístula Cutânea/etiologia , Embucrilato/uso terapêutico , Doenças da Vesícula Biliar/etiologia , Hemostase Endoscópica/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Fístula Pancreática/etiologia , Pancreatite/etiologia , Esplenopatias/etiologia , Adesivos Teciduais/uso terapêuticoRESUMO
This observational cohort study reports the short- and long-term clinical outcomes of 31 patients admitted for acute non-malignant, non-cirrhotic portal vein thrombosis (PVT) over a 10-year period. Patients had a mean age of 43 years at admission and a mean duration of follow-up of 84 months. All patients were initially treated with anticoagulants. Complete recanalization occurred within 30 days after admission in 18 patients (58%), partially in nine patients (29%), and failed in four patients (13%). During follow-up, 10 patients (32%) had at least one episode of gastrointestinal bleeding. The probability of remaining bleed-free was 0.93 at 24 months and 0.61 at 48 months. Fundal varices were not controlled by endoscopic sclerotherapy, so all four patients underwent portosystemic shunt construction. To date, there has been no mortality. In conclusion, using a combination of different treatment options reduces the risk of death and late complications in patients with non-malignant, non-cirrhotic PVT.
Assuntos
Cirrose Hepática/complicações , Veia Porta/patologia , Trombose Venosa/complicações , Adolescente , Adulto , Antibacterianos/uso terapêutico , Anticoagulantes/uso terapêutico , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Nutrição Parenteral , Escleroterapia , Tomografia Computadorizada Espiral , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/tratamento farmacológico , Trombose Venosa/fisiopatologia , Adulto JovemRESUMO
For various reasons some patients are unable to undergo intra-arterial thrombolysis for acute limb ischaemia. This interventional case series study prospectively evaluated the effect of thrombolytic treatment with 100 mg recombinant tissue plasminogen activator (rt-PA), administered intravenously, in patients with acute thrombosis of the lower limb arteries and onset of symptoms within 12 h prior to treatment. During a 3-year period (2007-2009), 18 of 86 patients satisfied the inclusion criteria and were included in the study (age range 65-80 years; 11 women). Complete and partial thrombolysis was observed in eight (44.4%) and six (33.3%) patients, respectively. All patients experienced clinical improvement. There were no amputations during the 36-month follow-up period and no haemorrhagic complications in the first 30 days post-treatment. Five patients died (27.8%) during follow-up from unrelated causes. This small study demonstrated that thrombolytic treatment with intravenous rt-PA in selected patients with acute limb ischaemia is feasible.
