Key result
TIPS plus local thrombolysis successfully restores venous outflow and lyses thrombi in severe Budd-Chiari syndrome.
Case Report (n=1)
TIPS followed by local thrombolytic therapy may be an effective treatment for severe thrombotic events like Budd-Chiari syndrome with portal and mesenteric vein thrombosis in patients with factor V Leiden mutation.
May support TIPS plus local thrombolysis in severe Budd-Chiari with factor V Leiden; hypothesis-generating and should not change practice.
We present the first case of Budd-Chiari syndrome in association with portal and mesenteric vein thrombosis in a patient homozygous for the factor V Leiden mutation. She was treated by transjugular intrahepatic portosystemic stent (TIPS) placement followed by local thrombolytic therapy. Venous outflow from the liver was established and the thrombi in the portal and mesenteric veins were lysed completely. This therapeutic approach may be used for such patients with this severe thrombotic event, who generally have a poor prognosis.
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Leebeek et al. (1998) conducted a case report in Budd-Chiari syndrome, portal vein and mesenteric vein thrombosis, homozygous for factor V Leiden mutation (n=1). TIPS placement followed by local thrombolytic therapy was evaluated on Venous outflow establishment and thrombus lysis. TIPS placement followed by local thrombolytic therapy successfully established venous outflow and completely lysed thrombi in a patient with severe Budd-Chiari syndrome and factor V Leiden mutation.
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