Consensus for Management of Portal Vein Thrombosis in Liver Cirrhosis (2020, Shanghai)

Overview

Journal J Dig Dis

Specialty Gastroenterology

Date 2021 Jan 20

PMID 33470535

Citations 26

Affiliations

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Abstract

Portal vein thrombosis (PVT) is a common and severe complication of liver cirrhosis. So far, there have been few consensuses or practice guidelines on the management of PVT in liver cirrhosis. In this expert consensus, we systematically review the epidemiology, risk factors, imaging examinations, diagnosis, assessment of disease severity, and treatment strategy of PVT in liver cirrhosis, based on the most recent evidence and expert opinions, to further standardize the diagnosis and treatment of the disease in clinical practice.

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References

Chen H, Trilok G, Wang F, Qi X, Xiao J, Yang C . A single hospital study on portal vein thrombosis in cirrhotic patients - clinical characteristics & risk factors. Indian J Med Res. 2014; 139(2):260-6. PMC: 4001338. View

Intagliata N, Argo C, Stine J, Lisman T, Caldwell S, Violi F . Concepts and Controversies in Haemostasis and Thrombosis Associated with Liver Disease: Proceedings of the 7th International Coagulation in Liver Disease Conference. Thromb Haemost. 2018; 118(8):1491-1506. PMC: 6202935. DOI: 10.1055/s-0038-1666861. View

Lv Y, Qi X, He C, Wang Z, Yin Z, Niu J . Covered TIPS versus endoscopic band ligation plus propranolol for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis: a randomised controlled trial. Gut. 2017; 67(12):2156-2168. DOI: 10.1136/gutjnl-2017-314634. View

Carnevale R, Raparelli V, Nocella C, Bartimoccia S, Novo M, Severino A . Gut-derived endotoxin stimulates factor VIII secretion from endothelial cells. Implications for hypercoagulability in cirrhosis. J Hepatol. 2017; 67(5):950-956. DOI: 10.1016/j.jhep.2017.07.002. View

Jiang T, Luo X, Sun J, Gao J . Clinical outcomes of transcatheter selective superior mesenteric artery urokinase infusion therapy transjugular intrahepatic portosystemic shunt in patients with cirrhosis and acute portal vein thrombosis. World J Gastroenterol. 2017; 23(41):7470-7477. PMC: 5685853. DOI: 10.3748/wjg.v23.i41.7470. View

Qi X, Chen H, Han G . Effect of antithrombin, protein C and protein S on portal vein thrombosis in liver cirrhosis: a meta-analysis. Am J Med Sci. 2012; 346(1):38-44. DOI: 10.1097/MAJ.0b013e31826485fc. View

Gemmati D, Serino M, Trivellato C, Fiorini S, SCAPOLI G . C677T substitution in the methylenetetrahydrofolate reductase gene as a risk factor for venous thrombosis and arterial disease in selected patients. Haematologica. 1999; 84(9):824-8. View

Zhao M, Yue Z, Zhao H, Wang L, Fan Z, He F . Techniques of TIPS in the treatment of liver cirrhosis combined with incompletely occlusive main portal vein thrombosis. Sci Rep. 2016; 6:33069. PMC: 5020493. DOI: 10.1038/srep33069. View

Smalberg J, Arends L, Valla D, Kiladjian J, Janssen H, Leebeek F . Myeloproliferative neoplasms in Budd-Chiari syndrome and portal vein thrombosis: a meta-analysis. Blood. 2012; 120(25):4921-8. DOI: 10.1182/blood-2011-09-376517. View

10.

Francoz C, Belghiti J, Vilgrain V, Sommacale D, Paradis V, Condat B . Splanchnic vein thrombosis in candidates for liver transplantation: usefulness of screening and anticoagulation. Gut. 2005; 54(5):691-7. PMC: 1774501. DOI: 10.1136/gut.2004.042796. View

11.

Qi X, De Stefano V, Li H, Dai J, Guo X, Fan D . Anticoagulation for the treatment of portal vein thrombosis in liver cirrhosis: a systematic review and meta-analysis of observational studies. Eur J Intern Med. 2015; 26(1):23-9. DOI: 10.1016/j.ejim.2014.12.002. View

12.

Senzolo M, Riva N, Dentali F, Rodriguez-Castro K, Sartori M, Bang S . Long-Term Outcome of Splanchnic Vein Thrombosis in Cirrhosis. Clin Transl Gastroenterol. 2018; 9(8):176. PMC: 6092393. DOI: 10.1038/s41424-018-0043-2. View

13.

Liu F, Wang M, Fan Q, Duan F, Wang Z, Song P . Interventional treatment for symptomatic acute-subacute portal and superior mesenteric vein thrombosis. World J Gastroenterol. 2009; 15(40):5028-34. PMC: 2768881. DOI: 10.3748/wjg.15.5028. View

14.

Gerwing M, Wilms C, Heinzow H, Sporns P, Heindel W, Schmidt H . Escalating interventional recanalization therapy in non-cirrhotic, non-malignant acute portal vein thrombosis. Eur J Gastroenterol Hepatol. 2019; 31(12):1584-1591. DOI: 10.1097/MEG.0000000000001559. View

15.

Cai M, Zhu K, Huang W, Meng X, He K, Zhou B . Portal vein thrombosis after partial splenic embolization in liver cirrhosis: efficacy of anticoagulation and long-term follow-up. J Vasc Interv Radiol. 2013; 24(12):1808-16. DOI: 10.1016/j.jvir.2013.08.018. View

16.

Amitrano L, Guardascione M, Menchise A, Martino R, Scaglione M, Giovine S . Safety and efficacy of anticoagulation therapy with low molecular weight heparin for portal vein thrombosis in patients with liver cirrhosis. J Clin Gastroenterol. 2009; 44(6):448-51. DOI: 10.1097/MCG.0b013e3181b3ab44. View

17.

Xu X, Guo X, De Stefano V, Silva-Junior G, Goyal H, Bai Z . Nonselective beta-blockers and development of portal vein thrombosis in liver cirrhosis: a systematic review and meta-analysis. Hepatol Int. 2019; 13(4):468-481. DOI: 10.1007/s12072-019-09951-6. View

18.

Ma S, Wang J, Bezinover D, Kadry Z, Northup P, Stine J . Inherited thrombophilia and portal vein thrombosis in cirrhosis: A systematic review and meta-analysis. Res Pract Thromb Haemost. 2019; 3(4):658-667. PMC: 6781918. DOI: 10.1002/rth2.12253. View

19.

Bauersachs R, Berkowitz S, Brenner B, Buller H, Decousus H, Gallus A . Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med. 2010; 363(26):2499-510. DOI: 10.1056/NEJMoa1007903. View

20.

Senzolo M, Burra P, Patch D, Burroughs A . Tips for portal vein thrombosis (pvt) in cirrhosis: not only unblocking a pipe. J Hepatol. 2011; 55(4):945-6. DOI: 10.1016/j.jhep.2011.02.027. View