BackTable Vascular & Interventional Ep. 541 Treatment of Acute Portal Vein Thrombosis with Dr. Ben May
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May 6, 2025 Dr. Ben May, an Interventional Radiologist at Weill Cornell Medicine, specializes in hepatobiliary services and shares his expertise on acute portal vein thrombosis. He discusses the need for effective treatment options beyond anticoagulation, especially for younger patients. Dr. May highlights innovative techniques such as suction thrombectomy and the importance of personalized interventions based on clot characteristics. He also emphasizes collaborative practices in managing complex cases and offers practical tips for successful thrombectomy procedures.
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Acute vs Chronic PVT Risks
- Acute portal vein thrombosis risks bowel ischemia, which can be deadly.
- Chronic untreated thrombosis leads to mesenteric hypertension with severe complications like varices and ascites.
Timing Matters in Acute PVT
- Acute portal vein thrombosis is best intervened within the first month.
- Clot turns harder and less removable after four to six weeks making late intervention difficult.
Non-Cirrhotic Acute PVT Presentation
- Non-cirrhotic patients with acute PVT usually present with vague acute abdominal pain.
- Many have extensive portomesenteric clot with diverse underlying causes, including hypercoagulable states and post-surgical events.