Percutaneous radiofrequency ablation of hepatocellular carcinoma in the presence of portal vein thrombosis

Neeman, Ziv; Libutti, Steven K.; Patti, Jay W.; Wood, Bradford J.

doi:10.1016/s0899-7071(03)00015-9

Cited by 16 publications

(8 citation statements)

References 14 publications

(15 reference statements)

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“…Emerging evidence shows that selected patients could benefit from more aggressive treatment approaches. Patients with small HCC and PV obstruction can be safely treated with RFA [ 148 ] or yttrium-90 glass microspheres (Theraspheres) in cases of PV obstruction without cavernous transformation [ 149 ]. Likewise, conformal radiotherapy induced a 45.8% objective response rate for PV obstruction in HCC and may be considered an important treatment option [ 150 ].…”

Section: Treatment Options For Pvt In Cirrhosismentioning

confidence: 99%

Portal vein thrombosis in cirrhosis: diagnosis, natural history, and therapeutic challenges

Mantaka

Augoustaki

Kouroumalis

et al. 2018

aog

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Portal vein thrombosis (PVT) is a frequent complication in cirrhosis and its prevalence increases with disease severity. Several factors are involved in the development and progression of PVT. The challenge for the management of PVT is the precise evaluation of the bleeding risk as opposed to life-threatening extension of thrombosis. Nevertheless, the impact on the progression and outcome of liver disease is unclear. A critical evaluation of the available data discloses that treating PVT in cirrhotics is safe and effective. However, there are open issues, such as which anticoagulant could represent a safer therapeutic option, and when and for how long this treatment should be administered to cirrhotic patients with PVT.

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Section: Treatment Options For Pvt In Cirrhosismentioning

confidence: 99%

Portal vein thrombosis in cirrhosis: diagnosis, natural history, and therapeutic challenges

Mantaka

Augoustaki

Kouroumalis

et al. 2018

aog

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“…184 Patients with small HCC and PV obstruction can be safely treated with RFA. 185 Similarly Yttrium À90 glass microspheres (Theraspheres) appear to be safe and well tolerated in patients with portal vein obstruction without cavernous transformation. 186 Similarly conformal radiotherapy induced a 45.8% objective response rate for PV obstruction in HCC and may be considered an important treatment option.…”

Section: Portal Vein Obstruction In Hccmentioning

confidence: 99%

Portal Vein Thrombosis

Chawla

Bodh

2015

Journal of Clinical and Experimental Hepatology

149

147

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Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. ( J CLIN EXP HEPATOL 2015;5:22-40)

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“…Patients with PVT and small HCC can be safely treated with RFA 147 . Similarly, Yttrium ‐90 glass microspheres (Theraspheres) appear to be safe and well tolerated in patients with portal vein thrombosis without cavernous transformation 148, 149 .…”

Section: Pvt In Special Situationsmentioning

confidence: 99%

Review article: the modern management of portal vein thrombosis

Chawla

Duseja

Dhiman

2009

Aliment Pharmacol Ther

139

133

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Summary Background Portal vein thrombosis (PVT) is an important cause of portal hypertension. It may occur as such with or without associated cirrhosis and hepatocellular carcinoma. Information on its management is scanty. Aim To provide an update on the modern management of portal vein thrombosis. Information on portal vein thrombosis in patients with and without cirrhosis and hepatocellular carcinoma is also updated. Methods A pubmed search was performed to identify the literature using search items portal vein thrombosis‐aetiology and treatment and portal vein thrombosis in cirrhosis and hepatocellular carcinoma. Results Portal vein thrombosis occurs because of local inflammatory conditions in the abdomen and prothrombotic factors. Acute portal vein thrombosis is usually symptomatic when associated with cirrhosis and/or superior mesenteric vein thrombosis. Anticoagulation should be given for 3–6 months if detected early. If prothrombotic factors are identified, anticoagulation should be given lifelong. Chronic portal vein thrombosis usually presents with well tolerated upper gastrointestinal bleed. It is diagnosed by imaging, which demonstrates a portal cavernoma in place of a portal vein. Anticoagulation does not have a definite role, but bleeds can be treated with endotherapy or shunt surgery. Rarely liver transplantation may be considered. Conclusion Role of anticoagulation in chronic portal vein thrombosis needs to be further studied.

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Percutaneous radiofrequency ablation of hepatocellular carcinoma in the presence of portal vein thrombosis

Cited by 16 publications

References 14 publications

Portal vein thrombosis in cirrhosis: diagnosis, natural history, and therapeutic challenges

Portal vein thrombosis in cirrhosis: diagnosis, natural history, and therapeutic challenges

Portal Vein Thrombosis

Review article: the modern management of portal vein thrombosis

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