Local thrombolysis

A newer approach to treating inflammatory bowel disease-related thromboembolism

James H. Tabibian, Bennett E. Roth

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Goals: To review the experience with a relatively novel treatment, local thrombolysis, in patients with inflammatory bowel disease (IBD)-related thromboembolism (TE). Background: TE is an extraintestinal complication of IBD for which there are no clear treatment guidelines. Systemic treatment with anticoagulants or thrombolytics often raises fear of hemorrhagic complications, particularly hematochezia. Study: Cases of IBD-related and non-IBD-related TE treated with local thrombolysis were searched for in PubMed, reviewed, and grouped into anatomic areas. Outcomes in each anatomic area were compared between IBD and non-IBD patients. Due to the small number of IBD-related TE cases, a descriptive, not statistical, analysis was performed. Results: There were 17 cases of IBD-related TE treated with local thrombolysis grouped as follows: 7 of cerebral venous thrombosis, 3 of lower extremity arterial TE, 1 of deep vein thrombosis, 1 of upper extremity deep vein thrombosis, 3 of abdominal vein thrombosis, and 2 of inferior vena cava TE. Mean age was 32 (range, 14 to 50) years, and 13 of 17 patients were female. Twelve had ulcerative colitis, 3 had Crohn's disease, and 1 was indeterminate. Four of the 7 patients with active IBD had pretreatment hematochezia, 2 of whom had worsening of hematochezia secondary to treatment. The rates of radiologic resolution, clinical resolution, and hemorrhagic complications in the IBD patients were favorable in all the anatomic areas and were very similar to non-IBD patients. Conclusions: Local thrombolysis may be considered a viable therapeutic option for IBD-related TE. As more cases of local thrombolysis for IBD-related TE accumulate, further recommendations can be made as to the indications for its use.

Original languageEnglish (US)
Pages (from-to)391-398
Number of pages8
JournalJournal of Clinical Gastroenterology
Volume43
Issue number5
DOIs
StatePublished - May 2009

Fingerprint

Thromboembolism
Inflammatory Bowel Diseases
Gastrointestinal Hemorrhage
Venous Thrombosis
Upper Extremity Deep Vein Thrombosis
Therapeutics
Intracranial Thrombosis
Inferior Vena Cava
Ulcerative Colitis
PubMed
Crohn Disease
Anticoagulants
Fear
Lower Extremity
Veins
Thrombosis
Guidelines

Keywords

  • Gastrointestinal hemorrhage
  • Hematochezia
  • Inflammatory bowel disease
  • Thromboembolism
  • Thrombolytic therapy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Local thrombolysis : A newer approach to treating inflammatory bowel disease-related thromboembolism. / Tabibian, James H.; Roth, Bennett E.

In: Journal of Clinical Gastroenterology, Vol. 43, No. 5, 05.2009, p. 391-398.

Research output: Contribution to journalReview article

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