Treatment of the Portal Vein Thrombosis

The treatment of portal vein thrombosis is performed based on a symptomatic acute clot or an asymptomatic chronic clot and further depends on whether the underlying disease is cirrhosis or not. In all cirrhotic cases, attention should be paid to hemorrhagic complications. In particular, it is necessary to perform appropriate prophylactic endoscopic injection sclerotherapy/endoscopic variceal ligation in complicated case of esophagogastric varices. In recent years the use of antithrombin-III (AT-III) preparations and danaparoid sodium have increased in place of heparin, urokinase, and warfarin for the treatment of portal vein thrombosis. Based on the fact that antithrombotic action (fibrinolysis) has been reported even with AT-III alone, and that AT-III doesn’t affect the bleeding tendency, it is safe and effective to use it for portal vein thrombosis with esophagogastric varices. And danaparoid sodium has higher anti-factor Xa activity than heparin. In addition, the usefulness of danaparoid with less risk of bleeding has also been reported.