Treatment of portal vein thrombosis: an updated narrative review
- PMID: 33832217
- DOI: 10.23736/S0026-4806.21.07526-1
Treatment of portal vein thrombosis: an updated narrative review
Abstract
Portal vein thrombosis (PVT) is the most frequent among the splanchnic vein thrombosis, accounting for 90% of cases. More than half of PVT are provoked by liver cirrhosis, solid cancer or myeloproliferative neoplasms. The remaining cases are non-malignant non-cirrhotic PVT and include either unprovoked events or thrombosis secondary to other less common risk factors (e.g. abdominal surgery, intrabdominal inflammations/infections, or hormonal stimuli). Anticoagulant therapy in patients with acute symptomatic PVT should be started early after diagnosis, if no active bleeding, to obtain greater vessel recanalization and reduce the occurrence of portal-hypertension related complications. Gastroesophageal varices do not represent a contraindication to anticoagulant treatment, as long as adequate measures have been undertaken for the prophylaxis of gastroesophageal bleeding. Different treatment options (unfractionated or low molecular weight heparin, vitamin K antagonists and direct oral anticoagulants [DOACs]) can be considered. In this narrative review we will discuss the treatment of PVT in the three most common scenarios (cirrhosis-associated, cancer-associated and non-malignant non-cirrhotic PVT). We will also discuss the role of the DOACs and summarize recent guidelines on this topic.
Similar articles
-
Anticoagulant therapy for splanchnic vein thrombosis: recent updates for patients with liver cirrhosis.Expert Rev Hematol. 2023 Feb;16(2):121-129. doi: 10.1080/17474086.2023.2184340. Epub 2023 Feb 27. Expert Rev Hematol. 2023. PMID: 36820873 Review.
-
The Efficacy and Safety of Anticoagulants in the Treatment of Cirrhotic Portal Vein Thrombosis: A Systematic Review and Meta-Analysis.Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221104797. doi: 10.1177/10760296221104797. Clin Appl Thromb Hemost. 2022. PMID: 35656719 Free PMC article.
-
Treatment of direct oral anticoagulants in patients with liver cirrhosis and portal vein thrombosis.Clin Mol Hepatol. 2021 Oct;27(4):535-552. doi: 10.3350/cmh.2021.0109. Epub 2021 Jun 16. Clin Mol Hepatol. 2021. PMID: 34130370 Free PMC article. Review.
-
Anticoagulation in non-malignant portal vein thrombosis is safe and improves hepatic function.Wien Klin Wochenschr. 2018 Jul;130(13-14):446-455. doi: 10.1007/s00508-018-1351-y. Epub 2018 Jun 18. Wien Klin Wochenschr. 2018. PMID: 29916054 Free PMC article.
-
Effects of Anticoagulants in Patients With Cirrhosis and Portal Vein Thrombosis: A Systematic Review and Meta-analysis.Gastroenterology. 2017 Aug;153(2):480-487.e1. doi: 10.1053/j.gastro.2017.04.042. Epub 2017 May 4. Gastroenterology. 2017. PMID: 28479379 Review.
Cited by
-
Intestinal Obstruction as Initial Presentation of Idiopathic Portal and Mesenteric Venous Thrombosis: Diagnosis, Management, and Literature Review.Diagnostics (Basel). 2024 Jan 30;14(3):304. doi: 10.3390/diagnostics14030304. Diagnostics (Basel). 2024. PMID: 38337820 Free PMC article. Review.
-
Shedding Light on the Pathogenesis of Splanchnic Vein Thrombosis.Int J Mol Sci. 2023 Jan 23;24(3):2262. doi: 10.3390/ijms24032262. Int J Mol Sci. 2023. PMID: 36768584 Free PMC article. Review.
-
Rates, Reasons, and Independent Predictors of Readmissions in Portal Venous Thrombosis Hospitalizations in the USA.Gastroenterology Res. 2022 Oct;15(5):253-262. doi: 10.14740/gr1561. Epub 2022 Oct 19. Gastroenterology Res. 2022. PMID: 36407807 Free PMC article.
-
Risk factors for postoperative portal vein thrombosis in patients with hepatitis B liver cancer and its impact on mortality-a retrospective study.Transl Cancer Res. 2022 Aug;11(8):2858-2865. doi: 10.21037/tcr-22-1837. Transl Cancer Res. 2022. PMID: 36093521 Free PMC article.
-
Case Report: Pancreatic Neuroendocrine Tumor With Liver Metastasis and Portal Vein Thrombosis.Front Oncol. 2022 Feb 14;11:809129. doi: 10.3389/fonc.2021.809129. eCollection 2021. Front Oncol. 2022. PMID: 35237502 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical