A prediction model for successful anticoagulation in cirrhotic portal vein thrombosis

Abstract

Early diagnosis and early treatment are key factors for the successful management of PVT in cirrhosis, so that screening of PVT and prompt start of anticoagulant treatment should be mandatory.

Recent developments in the field of vascular liver diseases

“…However, no solid conclusions can be drawn from the extremely heterogeneous findings except for the negative influence of delaying the initiation of anticoagulation therapy by more than 6 months in two studies as previously suggested . In particular, results on the influence of the severity of liver disease (assessed by the MELD or Child Pugh scores) differed and showed a higher rate in most severe patients or in compensated patients . Extension and the degree of lumen occupancy were rarely identified as prognostic indicators for recanalization …”

“…63 Although many studies were small, most performed multivariate analyses to identify factors associated with recanalization. However, no solid conclusions can be drawn from the extremely heterogeneous findings except for the negative influence of delaying the initiation of anticoagulation therapy by more than 6 months in two studies 32,34 as previously suggested. 26 In particular, results on the influence of the severity of liver disease (assessed by the MELD or Child Pugh scores) differed and showed a higher rate in most severe patients 29,30 or in compensated patients.…”

“…Results on analyses to identify predictors for recanalization on anticoagulation therapy have been varied. The delay in initiating anticoagulation is the only consistent factor …”

“…In particular, results on the influence of the severity of liver disease (assessed by the MELD or Child Pugh scores) differed and showed a higher rate in most severe patients or in compensated patients . Extension and the degree of lumen occupancy were rarely identified as prognostic indicators for recanalization …”

“…The delay in initiating anticoagulation is the only consistent factor. [30][31][32][34][35][36] Two low-powered studies evaluated recurrence after spontaneous resolution, which was found to occur in 9 out of 20 patients 12 and 19 out of 89 patients 13…”