| Efficacy and safety of anticoagulation on patients with cirrhosis and portal vein thrombosis. | |
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MedLine Citation:
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PMID: 22289875 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND & AIMS: Portal vein thrombosis (PVT) is a frequent event in patients with cirrhosis; it can be treated with anticoagulants, but there are limited data regarding safety and efficacy of this approach. We evaluated this therapy in a large series of patients with cirrhosis and non-neoplastic PVT. METHODS: We analyzed data from 55 patients with cirrhosis and PVT, diagnosed from June 2003 to September 2010, who received anticoagulant therapy for acute or subacute thrombosis (n = 31) or progression of previously known PVT (n = 24). Patients with cavernomatous transformation were excluded. Thrombosis was diagnosed, and recanalization was evaluated by using Doppler ultrasound, angio-computed tomography, and/or angio-magnetic resonance imaging analyses. RESULTS: Partial or complete recanalization was achieved in 33 patients (60%; complete in 25). Early initiation of anticoagulation was the only factor significantly associated with recanalization. Rethrombosis after complete recanalization occurred in 38.5% of patients after anticoagulation therapy was stopped. Despite similar baseline characteristics, patients who achieved recanalization developed less frequent liver-related events (portal hypertension-related bleeding, ascites, or hepatic encephalopathy) during the follow-up period, but this difference was not statistically significant (P = .1). Five patients developed bleeding complications that were probably related to anticoagulation. A platelet count <50 × 109/L was the only factor significantly associated with higher risk for experiencing a bleeding complication. There were no deaths related to anticoagulation therapy. CONCLUSIONS: Anticoagulation is a relatively safe treatment that leads to partial or complete recanalization of the portal venous axis in 60% of patients with cirrhosis and PVT; it should be maintained indefinitely to prevent rethrombosis. |
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Authors:
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María Gabriela Delgado; Susana Seijo; Ismael Yepes; Linette Achécar; Maria Vega Catalina; Angeles García-Criado; Juan G Abraldes; Joaquín de la Peña; Rafael Bañares; Agustín Albillos; Jaume Bosch; Juan Carlos García-Pagán |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2012-01-28 |
Journal Detail:
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Title: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association Volume: 10 ISSN: 1542-7714 ISO Abbreviation: Clin. Gastroenterol. Hepatol. Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-06-22 Completed Date: 2012-10-16 Revised Date: 2013-05-01 |
Medline Journal Info:
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Nlm Unique ID: 101160775 Medline TA: Clin Gastroenterol Hepatol Country: United States |
Other Details:
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Languages: eng Pagination: 776-83 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Hepatic Hemodynamic Laboratory, Liver Unit, Institut de Malalties Digestives i Metaboliques, Hospital Clínic-Institut de Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angiography Anticoagulants / administration & dosage*, adverse effects* Axis Female Humans Liver Cirrhosis / complications* Male Middle Aged Portal Vein / pathology*, radiography, ultrasonography Radiography, Abdominal Tomography, X-Ray Computed Treatment Outcome Venous Thrombosis / drug therapy* |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants |
| Comments/Corrections | |
Comment In:
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Clin Gastroenterol Hepatol. 2012 Jul;10(7):820-1; author reply 821
[PMID:
22387253
]
Clin Gastroenterol Hepatol. 2013 Jan;11(1):103 [PMID: 22902778 ] Clin Gastroenterol Hepatol. 2013 Jan;11(1):103-4 [PMID: 23064025 ] Gastroenterology. 2013 Apr;144(4):848-51 [PMID: 23491832 ] Clin Gastroenterol Hepatol. 2012 Jul;10(7):784-5 [PMID: 22469993 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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