Transileocolic endovascular treatment by a hybrid approach for severe acute portal vein thrombosis with bowel necrosis:Two case reports

BACKGROUND Acute portal vein thrombosis(PVT)with bowel necrosis is a fatal condition with a 50%-75%mortality rate.This report describes the successful endovascular treatment(EVT)of two patients with severe PVT.CASE SUMMARY The first patient was a 22-year-old man who presented with abdominal pain lasting 3 d.The second patient was a 48-year-old man who presented with acute abdominal pain.Following contrast-enhanced computed tomography,both patients were diagnosed with massive PVT extending to the splenic and superior mesenteric veins.Hybrid treatment(simultaneous necrotic bowel resection and EVT)was performed in a hybrid operating room(OR).EVTs,including aspiration thrombectomy,catheter-directed thrombolysis(CDT),and continuous CDT,were performed via the ileocolic vein under laparotomy.The portal veins were patent 4 and 6 mo posttreatment in the 22-year-old and 48-year-old patients,respectively.CONCLUSION Hybrid necrotic bowel resection and transileocolic EVT performed in a hybrid OR is effective and safe.