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Previous Volume 346:1252-1253 April 18, 2002 Number 16 Next

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To the Editor: Portal–mesenteric venous thrombosis, a devastating complication of hypercoagulable states, is a good target for minimally invasive treatment. Kumar et al. (Dec. 6 issue)¹ ignored a growing body of work indicating that catheter-based therapy is an elegant and effective treatment that is far preferable to the trauma of open surgery. We have adopted transjugular catheterization of the occluded veins, the creation of a transjugular intrahepatic shunt, and local thrombolytic infusions as the primary treatment for patients with symptomatic mesenteric venous thrombosis. The transjugular intrahepatic shunt accelerates endogenous lysis during the procedure and then acts in a manner analogous . . . [Full Text of this Article]

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