Newer Oral Anticoagulants in the Treatment of Acute Portal Vein Thrombosis in Patients with and Without Cirrhosis

Overview

Journal Int J Hepatol

Publisher Wiley

Specialty Gastroenterology

Date 2018 Jul 6

PMID 29973997

Citations 32

Authors

P Priyanka

J T Kupec

M Krafft

N A Shah

G J Reynolds

Affiliations

Soon will be listed here.

Abstract

Background: Newer oral anticoagulants (NOACs) are being utilized increasingly for the treatment of venous thromboembolism (VTE). NOAC use is the standard of care for stroke prophylaxis in nonvalvular atrial fibrillation and treatment of acute VTE involving extremities and pulmonary embolism. In contrast, most guidelines in the literature support the treatment of acute portal vein thrombosis (PVT) with low molecular weight heparin (LMWH) and vitamin K antagonists (VKA). Literature evaluating NOAC use in the treatment of acute portal vein thrombosis is sparse. This review focuses on the safety and efficacy of the use of NOACs in the treatment of acute PVT in patients, with or without concomitant cirrhosis, based on the most recent data available in the current literature.

Methods: A systematic review was conducted through a series of advanced searches in the following medical databases: PubMed, BioMed Central, Cochrane, and Google Scholar. Keywords utilized were as follows: NOAC, DOAC (direct oral anticoagulants), portal vein thrombosis, rivaroxaban, apixaban, dabigatran, and edoxaban. Articles related to newer anticoagulant use in patients with portal vein thrombosis were included.

Results: The adverse events, including bleeding events (major and minor) and the failure of anticoagulation (propagation of thrombus or recurrence of PVT), are similar between the NOACs and traditional anticoagulants for the treatment of acute PVT, irrespective of the presence of cirrhosis.

Conclusions: Newer oral anticoagulants are safe and efficacious alternatives to traditional anticoagulation with low molecular weight heparin and vitamin K antagonists in the treatment of acute portal vein thrombosis with or without cirrhosis.

Citing Articles

Classification and Management of Portal Vein Thrombosis in Cirrhotic Patients: A Narrative Review.

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Kim Y, Kim H, Park S, Hwang D, Kim H, Huh S J Vasc Surg Venous Lymphat Disord. 2024; 12(5):101903.

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Intestinal obstruction induced by portal vein thrombosis in a female undergoing oral contraceptive therapy: a case report with comprehensive review.

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