Efficacy and safety of anticoagulation in non-malignant portal vein thrombosis in patients with liver cirrhosis

Artaza, T.; Lopes, Marcelo Barreto; Romero, M.; Gómez, Antonio; Cruz, G. de la; Sánchez, Juan José; González, Concepción; Gómez, R

doi:10.1016/j.gastrohep.2018.06.005

Cited by 19 publications

(12 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, the infrequent presence of myeloproliferative neoplasm (2.7%) is in line with previous studies in this setting [21,22,26,31,33]. Overall, our data show a low prevalence of thrombophilia, either inherited or acquired, which is in agreement with other previous reports that did not find an association between the presence of thrombophilia and the risk of PVT in patients with liver cirrhosis [11,16,21,22,24,27,28,30,33,39].…”

Section: Discussionsupporting

confidence: 93%

Portal Thrombosis in Cirrhosis: Role of Thrombophilic Disorders

Fortea

Carrera

Puente

et al. 2020

JCM

View full text Add to dashboard Cite

In patients with liver cirrhosis the contribution of inherited and acquired prothrombotic disorders in the development of non-malignant portal vein thrombosis (PVT) is inconclusive. The purpose of this retrospective study was to examine the prevalence of thrombophilia in this setting at our center from January 2012 to November 2019. Tests included gene mutational analysis for Factor V Leiden, prothrombin G20210A, JAK2 (V617F), Calreticulin (CARL), in addition to activated protein C resistance, antithrombin III, protein C and S levels, and antiphospholipid antibodies. We included 77 patients, six of whom (7.8%) had a thrombophilic disorder: antiphospholipid syndrome in four patients, prothrombin gene mutation in one and factor V Leiden mutation in one. This latter patient had also been diagnosed with polycythemia vera years before PVT development. Complete thrombosis of the main portal vein and re-thrombosis after stopping anticoagulation were more frequent in patients with thrombophilia, but the rates of recanalization under anticoagulant therapy were similar among groups. No other difference was accounted between groups. The low prevalence of acquired and inherited thrombophilia found in patients with cirrhosis and PVT support testing for these disorders on an individual basis and avoiding universal screening to reduce costs and unwarranted testing.

show abstract

Section: Discussionsupporting

confidence: 93%

Portal Thrombosis in Cirrhosis: Role of Thrombophilic Disorders

Fortea

Carrera

Puente

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…Main characteristics of studies are summarized in Table 1. The sample size ranged from 16 [14,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] and 14 as abstracts [38][39][40][41][42][43][44][45][46][47][48][49][50][51].…”

Section: Included Studiesmentioning

confidence: 99%

“…Main characteristics of patients are summarized in Supplementary Table 2 [14,25,30,35,36], three excluded patients receiving antiplatelet treatment [25,28,35], and one excluded patients receiving thrombolytic treatment [14].…”

Section: Included Studiesmentioning

confidence: 99%

Anticoagulation Favors Thrombus Recanalization and Survival in Patients With Liver Cirrhosis and Portal Vein Thrombosis: Results of a Meta-Analysis

Wang

Guo

et al. 2020

Adv Ther

View full text Add to dashboard Cite

Introduction: Benefit and risk of anticoagulation in cirrhotic patients with portal vein thrombosis (PVT) remain controversial, especially in those with asymptomatic PVT and in non-liver transplant candidates. Furthermore, the predictors of portal vein recanalization and bleeding events after anticoagulation are critical for making clinical decisions, but still unclear. We conducted a meta-analysis to investigate the outcomes of anticoagulation for PVT in liver cirrhosis and explore the predictors of portal vein recanalization and bleeding events after anticoagulation. Methods: All studies regarding anticoagulation for PVT in liver cirrhosis were searched via PubMed, EMBASE, and Cochrane Library databases. Thrombotic outcomes, bleeding events, and survival were compared between anticoagulation and non-anticoagulation groups. Predictors of portal vein recanalization and bleeding events were pooled. Risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Results: Thirty-three studies including 1696 cirrhotic patients with PVT were included. Anticoagulation significantly increased portal Electronic supplementary material The online version of this article (

show abstract

“…18 Due to the lack of randomized controlled trials (RCTs) against placebo, current data on the magnitude of anticoagulation efficacy is mostly based on retrospective cohort studies. With these limitations, the reported rate of recanalization using traditional anticoagulants, with similar efficacy of VKAs and LMWH, ranges between 39 and 75% for any degree of recanalization 7,42,49,[53][54][55][56][57] and between 33 and 45% for complete recanalization. 58 The only factor associated with a higher probability of recanalization is a short interval between thrombus formation and initiation of anticoagulation (< 14 days in one study 55 or < 6 months in others 43,59 ).…”

Section: Anticoagulationmentioning

confidence: 99%

“…42,62,69 The presence of severe thrombocytopenia (platelets < 50 Â 10 9 /L) has been suggested to be associated with a higher risk of bleeding in cirrhotic patients; however, the results are conflicting. 27,54,55,70 When DOACs are compared with traditional anticoagulants, although both treatments display similar safety profile in terms of total bleeding episodes, DOACs have less cerebral hemorrhage than traditional anticoagulants, 71,72 particularly VKAs. 73,74 However, another study found similar risks in major bleedings 64 and the need of further studies is evident.…”

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

View full text Add to dashboard Cite

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.

show abstract

Efficacy and safety of anticoagulation in non-malignant portal vein thrombosis in patients with liver cirrhosis

Cited by 19 publications

References 22 publications

Portal Thrombosis in Cirrhosis: Role of Thrombophilic Disorders

Portal Thrombosis in Cirrhosis: Role of Thrombophilic Disorders

Anticoagulation Favors Thrombus Recanalization and Survival in Patients With Liver Cirrhosis and Portal Vein Thrombosis: Results of a Meta-Analysis

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

Contact Info

Product

Resources

About