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

Aikaterini Mantaka, Aikaterini Augoustaki, Elias A Kouroumalis, Dimitrios N Samonakis, Aikaterini Mantaka, Aikaterini Augoustaki, Elias A Kouroumalis, Dimitrios N Samonakis

Abstract

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.

Keywords: Portal vein thrombosis; anticoagulants; bleeding; cirrhosis; direct oral anticoagulants.

Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
Pathophysiological aspects in portal vein thrombosis in cirrhosis HCC, hepatocellular carcinoma.
Figure 2
Figure 2
Portal vein thrombosis in cirrhosis: algorithm for diagnosis and treatment CT, computed tomography; MRI, magnetic resonance imaging; CEUS contrast-enhanced ultrasonography; HCC, hepatocellular carcinoma; PVT, portal vein thrombosis; TACE, transarterial chemoembolization; RFA, radiofrequency ablation; TIPS, transjugular intrahepatic portosystemic shunt; LT, liver transplantation.

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Source: PubMed

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