| 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: Publisher |
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 is 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 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, during the follow-up period, less-frequent liver-related events (portal hypertension-related bleeding, ascites, or hepatic encephalopathy), but this difference was not statistically significant (P=.1). Five patients developed bleeding complications that were probably related to anticoagulation. A platelet count <50x109/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 Date: 2012-1-27 |
Journal Detail:
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Title: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association Volume: - ISSN: 1542-7714 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101160775 Medline TA: Clin Gastroenterol Hepatol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
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. Spain. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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