Interventional management of in-stent thrombosis after superior mesenteric vein stenting

Introduction: Mesenteric vein stenosis and thrombosis are rare conditions, without a definite treatment strategy. Report: A 46 year-old man underwent pancreatic resection with a polytetrafluoroethylene (PTFE) graft vascular reconstruction; he subsequently developed anastomotic mesenteric vein stenosis, which was treated with transhepatic venoplasty and stenting. Three months later, he suffered an in-stent thrombosis, after a reduction in heparin dosage. The thrombosis was successfully managed, after a failed systemic thrombolysis, with a direct thrombolysis via transjugular approach. At 10 months' follow-up, the stent was still patent. Conclusion: Mesenteric vein stenting is effective on PTFE grafts, but appropriate anticoagulation is helpful to avoid subsequent in-stent thrombosis.