Mesenteric Venous Thrombosis

Singal, Ashwani K.; Kamath, Patrick S.; Tefferi, Ayalew

doi:10.1016/j.mayocp.2013.01.012

Cited by 188 publications

(217 citation statements)

References 53 publications

(29 reference statements)

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“…However, numerous hospitals do not have the ability to apply these techniques due to the high technical requirement. In addition, transjugular intrahepatic portosystemic shunt is only recommended when anticoagulation is unsuccessful and the clinical condition worsens (20), due to the technical difficulties in constructing the shunt in the absence of a normal anatomy of the portal and the hepatic vein systems in hepatic and portal vein thrombosis patients (29). The indications include extensive thromboses, severe symptoms, and persistent or worsening symptoms despite anticoagulation (11), and thus the use of this technique is limited and can not be administered to all patients.…”

Section: Discussionmentioning

confidence: 99%

“…The degree of lysis in each case was determined by two radiologists independently (10). Once clinical and radiographic improvement was noted, warfarin (Qilu Pharmaceutical Co., Ltd., Jinan, China) therapy was initiated at a dose of 2.5 mg/as a long-term therapy, outside of hospital treatment (20). When the international normalized ratio (INR) reached the target range of 2-3, argatroban was discontinued and warfarin alone was continued.…”

Section: Methodsmentioning

confidence: 99%

“…Subsequently, the patient was discharged from hospital. The duration of oral anticoagulation was ~6 months for patients with known reversible factors, however this treatment was lifelong for patients who suffered from the idiopathic or with prothrombotic states (20). Recurrence was defined as the symptoms recurring due to the disease, while other causes were ruled out, and when the CT scan indicated that the thrombus was not significantly altered or was even worsened compared with the observation at hospital discharge.…”

Section: Methodsmentioning

confidence: 99%

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Early initiation of argatroban therapy in the management of acute superior mesenteric venous thrombosis

Zeng

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Acute superior mesenteric venous thrombosis (ASMVT) is an intractable disease with poor prognosis. Argatroban, a direct thrombin inhibitor, may be a novel anticoagulant method in the therapy of ASMVT. The aim of the present study was to assess the efficacy and safety of early argatroban therapy in ASMVT patients. The current retrospective study reviewed a consecutive series of ASMVT patients receiving early argatroban therapy during hospitalization between March 2013 and April 2014, with 18 ASMVT patients included in the study. Of these, 16 patients without hepatic dysfunction underwent anticoagulant therapy with argatroban with a mean dose of 1.57±0.34 µg/kg/min and a mean duration of 12.2±3.7 days, while their activated partial thromboplastin time (aPTT) was elevated to 1.95±0.26 times the baseline value. In addition, 2 hepatic dysfunction patients received therapy with a dose of 0.41 µg/kg/min and 0.46 µg/kg/min, and with aPTT of 1.68 and 1.62 times the baseline value, respectively. Overall, 94% (n=17) of the patients presented clinical improvement, while 88% (n=16) of patients presented partially or completely dissolved thrombus in contrast-enhanced computed tomography images. The incidence of surgery and bowel resection was 6% (excluding 1 case with intestinal necrosis detected on admission). Furthermore, 11% (n=2) of patients experienced a bleeding episode, however no major bleeding or mortality occurred during hospitalization. During the follow-up, the mortality and the recurrence rate were 6% and 11%, respectively. In conclusion, early initiation of argatroban treatment may be an effective and safe therapy in ASMVT, manifesting efficient resolution of the thrombus, rapid improvement of symptoms, low incidence of bowel resection and bleeding complication, and low mortality rate.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Early initiation of argatroban therapy in the management of acute superior mesenteric venous thrombosis

Zeng

et al. 2017

Experimental and Therapeutic Medicine

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“…5 Between 6% and 29% of patients with acute MVT are hemodynamically unstable on presentation. 6 In subacute and chronic MVT, patients may be asymptomatic or present with only vague, intermittent abdominal pain owing to the presence of collateral vessels. In 1 study, >50% of patients with subacute MVT reported a history of intermittent abdominal pain for up to a month before seeking medical evaluation.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…1 Anticoagulation results in venous recanalization over time. 6 Intravenous unfractionated heparin is preferred over low-molecularweight heparin in patients who may potentially undergo surgical intervention or receive fibrinolytic therapy.…”

Section: Anticoagulationmentioning

confidence: 99%

Mesenteric Venous Thrombosis

2015

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Portal and Mesenteric Venous Thrombosis

Kodali

Singal

2020

Clin. Liver Dis.

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The main portal vein (PV) is formed with superior mesenteric and splenic veins joining at the posterior aspect of pancreas; it carries blood from the gastrointestinal tract to contribute 70% of the hepatic blood supply. Similar to venous thrombosis at any other site, PV thrombosis (PVT) and/or mesenteric vein thrombosis (MVT) can be caused by vascular endothelial injury, sluggish blood flow, or underlying thrombophilia (Table 1). 1-4 Cirrhosis is the underlying etiology in about 22% to 28% of cases based on a large population-based autopsy study. 5 Among patients with cirrhosis, the prevalence rate of PVT varies depending on the severity of the liver disease (1% in compensated cirrhosis to 25% among patients listed for liver transplantation [LT]), 3,5 modality used for diagnosis, etiology of cirrhosis (more common among patients with nonalcoholic steatohepatitis), 6 and length of follow-up of patients with cirrhosis. In a recent longitudinal study, the cumulative incidence rate of PVT was 4.6%, 8.2%, and 10.7% at 1, 3, and 5 years, respectively. 4 PVT may be acute or chronic, partial or complete, occlusive or nonocclusive, when all etiologies for PVT are considered. Further, among patients with cirrhosis, this could be caused by bland or tumor thrombus.

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Mesenteric Venous Thrombosis

Cited by 188 publications

References 53 publications

Early initiation of argatroban therapy in the management of acute superior mesenteric venous thrombosis

Early initiation of argatroban therapy in the management of acute superior mesenteric venous thrombosis

Mesenteric Venous Thrombosis

Portal and Mesenteric Venous Thrombosis

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