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| Moving to multidisciplinary paradigm of managing splanchnic vein thrombosis Jonathan Berry. |
Abstract
Splanchnic vein thrombosis (SVT) — encompassing portal, mesenteric, and splenic vein thrombosis — affects approximately 3.7 per 100,000 persons annually in the general population, with a 1,000-fold higher incidence among patients with cirrhosis. Despite rising recognition, SVT poses distinct clinical challenges that cut across multiple specialties. This talk presents a practical five-step framework for managing SVT: assessing severity, formulating an anticoagulation plan, determining the need for interventional procedures, identifying underlying prothrombotic causes, and guiding long-term surveillance and management. Clinical evidence supporting DOAC use, the significance of thrombophilic states, and the evolving role of IR in portal recanalization are reviewed.
The second half describes the development and outcomes of a dedicated Splanchnic Vein Thrombosis Multidisciplinary Clinic at BIDMC, a novel model integrating hematology, hepatology, and interventional radiology in a co-located clinic. It outlines lessons learned and helps create a roadmap for others looking to tackle SVT in a multidisciplinary fashion.
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