Document Detail


Natural course of extrahepatic nonmalignant partial portal vein thrombosis in patients with cirrhosis.
MedLine Citation:
PMID:  22891357     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To define the natural course of extrahepatic nonmalignant partial portal vein thrombosis (PVT), including the progression from partial to complete PVT, in patients with cirrhosis who had undergone multidetector computed tomography (CT).
MATERIALS AND METHODS: This study was institutional review board and ethics committee approved. Written informed consent was obtained for each procedure. Forty-two consecutive patients with cirrhosis and untreated extrahepatic, nonmalignant partial PVT were followed up until the final clinical evaluation, liver transplantation, or death. Multidetector CT was used to evaluate the thrombus lumen occlusion, patent lumen area, thrombus area, total lumen area, and diameter of main portal vein, superior mesenteric vein, and splenic vein. Statistical analysis was performed with the Wilcoxon Mann-Whitney U test, χ2 test, Wilcoxon matched-pairs signed-rank test, life-table analysis, Kaplan-Meier method, and log-rank test, as appropriate.
RESULTS: After a mean follow-up period of 27 months, partial PVT worsened in 20 (48%) patients, improved in 19 (45%), and was stable in three (7%). The Kaplan-Meier probability of episodes of hepatic decompensation at 1 and 2 years was 41% and 57%; probability of hospital admission for hepatic decompensation, 37% and 54%; and survival rates, 77% and 57%, respectively. There was no clear association between progression or regression of partial PVT and clinical outcome. Multivariate analysis showed that the Child-Pugh score at diagnosis was the only independent predictor of survival (hazard ratio, 1.97; 95% confidence interval: 1.19, 3.23; P=.007) and hepatic decompensation (hazard ratio, 1.51; 95% confidence interval: 1.18, 1.19; P=.001).
CONCLUSION: Extrahepatic nonmalignant partial PVT improved spontaneously in 45% of patients with cirrhosis, and the progression of partial PVT was not associated with clinical outcome, which appeared to be dependent on the severity of cirrhosis.
Authors:
Angelo Luca; Settimo Caruso; Mariapina Milazzo; Gianluca Marrone; Giuseppe Mamone; Francesca Crinò; Luigi Maruzzelli; Roberto Miraglia; Gaetano Floridia; Giovanni Vizzini
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Publication Detail:
Type:  Journal Article     Date:  2012-08-13
Journal Detail:
Title:  Radiology     Volume:  265     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-20     Completed Date:  2012-12-03     Revised Date:  2013-04-02    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  124-32     Citation Subset:  AIM; IM    
Copyright Information:
© RSNA, 2012.
Affiliation:
Department of Diagnostic and Therapeutics Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies, Via Tricomi 1, 90127 Palermo, Italy. aluca@ismett.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chi-Square Distribution
Contrast Media / diagnostic use
Disease Progression
Female
Humans
Liver Cirrhosis / pathology*,  radiography
Male
Middle Aged
Portal Vein / pathology*,  radiography
Remission, Spontaneous
Retrospective Studies
Statistics, Nonparametric
Survival Analysis
Tomography, X-Ray Computed*
Venous Thrombosis / pathology*,  radiography
Chemical
Reg. No./Substance:
0/Contrast Media
Comments/Corrections
Comment In:
Radiology. 2013 Mar;266(3):994-5   [PMID:  23431230 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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