Anticoagulation for portal vein thrombosis in cirrhosis

Intagliata, Nicolas M.; Ferreira, Carlos Noronha; Caldwell, Stephen H.

doi:10.1002/cld.552

Cited by 8 publications

(23 citation statements)

References 20 publications

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“…Limited data on the natural behavior of VT has led to uncertainty in clinical management. (15,(23)(24)(25)(26)(27)(28). To our knowledge this is one of very few studies investigating the impact of visceral thromboses (PV, MV, SV, RV, GV, HV) in PDAC only, along with the radiologic methods employed to diagnose it, course of therapy and outcomes for VT.…”

Section: Discussionmentioning

confidence: 99%

Incidence, Management, and Implications of Visceral Thrombosis in Pancreatic Ductal Adenocarcinoma

Mier-Hicks

Raj

Kinh

et al. 2018

Clinical Colorectal Cancer

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Section: Discussionmentioning

confidence: 99%

Incidence, Management, and Implications of Visceral Thrombosis in Pancreatic Ductal Adenocarcinoma

Mier-Hicks

Raj

Kinh

et al. 2018

Clinical Colorectal Cancer

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“…It is now well established that patients with cirrhosis may experience both bleeding and thrombosis. Thrombotic complications include intrahepatic thrombosis, thrombosis of the portal veins, deep veins of the lower extremities, and pulmonary thromboembolism [4,5,[20][21][22][23].…”

Section: Thrombosis In Liver Cirrhosismentioning

confidence: 99%

“…Portal vein thrombosis is a recognized phenomenon in patients with liver cirrhosis, which makes it possible to consider liver cirrhosis as one of the main causes of its occurrence. There is a clear correlation between PVT and more severe portal hypertension [20,23]. The prevalence of PVT increases with the progression of cirrhosis, being in less than 1% of patients with a compensated stage and more than 8-26% (up to 50%) in candidates for liver transplantation.…”

Section: Portal Vein Thrombosismentioning

confidence: 99%

The Nature of Changes in the Hemostatic System in Liver Cirrhosis

Saitovich¹,

Stepanivna²

2021

EJCBS

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The nature of violations of the hemostatic system in liver cirrhosis is complex, often unpredictable and concerns all its links -vascular-platelet, coagulation and fibrinolysis. It is now well established that patients with cirrhosis may experience both bleeding and thrombosis. The mechanisms of blood clotting disorders in this case are very complex, since defects simultaneously occur both in the procoagulant system and in the anticoagulation system. Aim to study the factors and mechanism of the development of hemostasis imbalance in patients with liver cirrhosis based on the analysis of scientific literature, to determine the information content of existing laboratory tests for the study of hemostasis and the features of correction of hemostasis disorders depending on hyper-or hypocoagulation. It is generally accepted that cirrhosis results in a state of hypocoagulation with an increased tendency to bleeding. However, a number of publications do not support this opinion, and the interpretation of laboratory parameters is explained by the standard methodology, where the procoagulant and antifibrinolytic systems of hemostasis are insufficiently studied. Many researchers have established a state of hypercoagulability in liver cirrhosis, leading to intra-and extrahepatic thrombosis. The cause of bleeding, primarily from varicose veins of the esophagus and stomach, is not hypocoagulation as such, but rupture of varices due to hemodynamic disturbances with increased portal pressure, one of which is thrombosis. Accordingly, therapeutic tactics should be aimed, first of all, not at normalizing laboratory tests, but at eliminating the pathogenetic mechanisms of hemostatic imbalance that occur in liver cirrhosis. At the same time, drug correction should be directed not at individual links of the hemostasis system -pro or anticoagulant, but at the correction of hemostatic imbalance as a whole. Conclusions. To date questions about the nature of changes in the hemostasis system in liver cirrhosis, their relationship with hemorrhagic complications or thrombosis, the principles of drug correction remain open, requiring further research in this direction.

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“…However, when it occurs, mortality is high, depending on age, comorbidities, timing of diagnosis, and surgical interventions. 40 In other clinical scenarios, evidence is limited. There are arguments for and against treatment based on thrombosis extension, spontaneous evolution of the thrombus (progression vs. regression), and the potential impact that thrombosis may have on the natural history of cirrhosis.…”

Section: Treatment Of Portal Vein Thrombosis In Non-liver Transplant mentioning

confidence: 99%

“…Traditional anticoagulants (vitamin K antagonists [VKAs]/ low-molecular-weight heparin [LMWH]) or direct oral anticoagulants (DOACs) have proven effective in achieving recanalization. 18,40 Imaging on follow-up is the best way to assess recanalization. There is no evidence to recommend a specific timing or type of imaging study.…”

Section: Anticoagulationmentioning

confidence: 99%

New Insights into the Pathogenesis, Risk Factors, and Treatment of Portal Vein Thrombosis in Patients with Cirrhosis

Nicoară-Farcău

Soy

Magaz

et al. 2020

Semin Thromb Hemost

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Portal vein thrombosis (PVT) is a frequent event in patients with cirrhosis regardless of etiology. Notwithstanding the commonality of the problem, the pathophysiology and risk factors for PVT in cirrhosis are largely unknown. The clinical impact of PVT in the natural history of cirrhosis is unclear, indications for PVT treatment are not well defined, and treatment recommendations are based on experts' opinion and consensus only. Therefore, this review aims to summarize current knowledge of mechanisms and risk factors for PVT development and assess the current evidence of PVT management, with a special focus on strategies of anticoagulation and transjugular intrahepatic portosystemic shunt placement.

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Anticoagulation for portal vein thrombosis in cirrhosis

Abstract: http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/7-6-reading-intagliata.html a video presentation of this article

Cited by 8 publications

References 20 publications

Incidence, Management, and Implications of Visceral Thrombosis in Pancreatic Ductal Adenocarcinoma

Incidence, Management, and Implications of Visceral Thrombosis in Pancreatic Ductal Adenocarcinoma

The Nature of Changes in the Hemostatic System in Liver Cirrhosis

New Insights into the Pathogenesis, Risk Factors, and Treatment of Portal Vein Thrombosis in Patients with Cirrhosis

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