[Acute thrombosis of the portal system. Treatment with alteplase and heparin or with heparin alone in 10 patients]

Author(s): Lagasse JP, Bahallah ML, Salem N, Debillon G, Labarriere D, Serve MP, Advenier V, Causse X, Legoux JL

Affiliation(s): Service d'Hepato-Gastroenterologie, CHR, Orleans.

Publication date & source: 1997, Gastroenterol Clin Biol., 21(12):919-23.

Publication type: Clinical Trial; Clinical Trial, Phase II; Randomized Controlled Trial

OBJECTIVES: We report the efficacy of alteplase (a recombinant tissue plasminogen activator) with heparin or heparin alone in the treatment of acute thrombosis of the portal venous system. METHODS: Ten consecutive patients with acute portal venous system thrombosis were studied. Five patients were treated with alteplase and heparin, and the remaining 5 patients, who were asymptomatic or had a contraindication to alteplase, were treated with heparin alone. RESULTS: In 3 of the 5 patients treated with alteplase, ultrasonography showed total resolution of the thrombus; the remaining 2 had partial resolution of the thrombus. In 4 of the 5 patients treated with heparin alone, ultrasonography showed total resolution of the thrombus, and no change in one. No bleeding occurred. CONCLUSION: Treatment with heparin can result in complete recanalisation of acute portal venous system thrombosis. These data suggest that combined therapy with systemic alteplase does not increase the efficacy of heparin.