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Comparison of Non-Tumoral Portal Vein Thrombosis Management in Cirrhotic Patients: TIPS Versus Anticoagulation Versus No Treatment

Background: There is a lack of consensus in optimal management of portal vein thrombosis (PVT) in patients with cirrhosis. The purpose of this study is to compare the safety and thrombosis burden change for cirrhotic patients with non-tumoral PVT managed by transjugular intrahepatic portosystemic sh...

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Autores principales: Zhan, Chenyang, Prabhu, Vinay, Kang, Stella K., Li, Clayton, Zhu, Yuli, Kim, Sooah, Olsen, Sonja, Jacobson, Ira M., Dagher, Nabil N., Carney, Brendan, Hickey, Ryan M., Taslakian, Bedros
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8198761/
https://www.ncbi.nlm.nih.gov/pubmed/34073236
http://dx.doi.org/10.3390/jcm10112316
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author Zhan, Chenyang
Prabhu, Vinay
Kang, Stella K.
Li, Clayton
Zhu, Yuli
Kim, Sooah
Olsen, Sonja
Jacobson, Ira M.
Dagher, Nabil N.
Carney, Brendan
Hickey, Ryan M.
Taslakian, Bedros
author_facet Zhan, Chenyang
Prabhu, Vinay
Kang, Stella K.
Li, Clayton
Zhu, Yuli
Kim, Sooah
Olsen, Sonja
Jacobson, Ira M.
Dagher, Nabil N.
Carney, Brendan
Hickey, Ryan M.
Taslakian, Bedros
author_sort Zhan, Chenyang
collection PubMed
description Background: There is a lack of consensus in optimal management of portal vein thrombosis (PVT) in patients with cirrhosis. The purpose of this study is to compare the safety and thrombosis burden change for cirrhotic patients with non-tumoral PVT managed by transjugular intrahepatic portosystemic shunt (TIPS) only, anticoagulation only, or no treatment. Methods: This single-center retrospective study evaluated 52 patients with cirrhosis and non-tumoral PVT managed by TIPS only (14), anticoagulation only (11), or no treatment (27). The demographic, clinical, and imaging data for patients were collected. The portomesenteric thrombosis burden and liver function tests at early follow-up (6–9 months) and late follow-up (9–16 months) were compared to the baseline. Adverse events including bleeding and encephalopathy were recorded. Results: The overall portomesenteric thrombosis burden improved in eight (72%) TIPS patients, three (27%) anticoagulated patients, and two (10%) untreated patients at early follow-up (p = 0.001) and in seven (78%) TIPS patients, two (29%) anticoagulated patients, and three (17%) untreated patients in late follow-up (p = 0.007). No bleeding complications attributable to anticoagulation were observed. Conclusion: TIPS decreased portomesenteric thrombus burden compared to anticoagulation or no treatment for cirrhotic patients with PVT. Both TIPS and anticoagulation were safe therapies.
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spelling pubmed-81987612021-06-14 Comparison of Non-Tumoral Portal Vein Thrombosis Management in Cirrhotic Patients: TIPS Versus Anticoagulation Versus No Treatment Zhan, Chenyang Prabhu, Vinay Kang, Stella K. Li, Clayton Zhu, Yuli Kim, Sooah Olsen, Sonja Jacobson, Ira M. Dagher, Nabil N. Carney, Brendan Hickey, Ryan M. Taslakian, Bedros J Clin Med Article Background: There is a lack of consensus in optimal management of portal vein thrombosis (PVT) in patients with cirrhosis. The purpose of this study is to compare the safety and thrombosis burden change for cirrhotic patients with non-tumoral PVT managed by transjugular intrahepatic portosystemic shunt (TIPS) only, anticoagulation only, or no treatment. Methods: This single-center retrospective study evaluated 52 patients with cirrhosis and non-tumoral PVT managed by TIPS only (14), anticoagulation only (11), or no treatment (27). The demographic, clinical, and imaging data for patients were collected. The portomesenteric thrombosis burden and liver function tests at early follow-up (6–9 months) and late follow-up (9–16 months) were compared to the baseline. Adverse events including bleeding and encephalopathy were recorded. Results: The overall portomesenteric thrombosis burden improved in eight (72%) TIPS patients, three (27%) anticoagulated patients, and two (10%) untreated patients at early follow-up (p = 0.001) and in seven (78%) TIPS patients, two (29%) anticoagulated patients, and three (17%) untreated patients in late follow-up (p = 0.007). No bleeding complications attributable to anticoagulation were observed. Conclusion: TIPS decreased portomesenteric thrombus burden compared to anticoagulation or no treatment for cirrhotic patients with PVT. Both TIPS and anticoagulation were safe therapies. MDPI 2021-05-26 /pmc/articles/PMC8198761/ /pubmed/34073236 http://dx.doi.org/10.3390/jcm10112316 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zhan, Chenyang
Prabhu, Vinay
Kang, Stella K.
Li, Clayton
Zhu, Yuli
Kim, Sooah
Olsen, Sonja
Jacobson, Ira M.
Dagher, Nabil N.
Carney, Brendan
Hickey, Ryan M.
Taslakian, Bedros
Comparison of Non-Tumoral Portal Vein Thrombosis Management in Cirrhotic Patients: TIPS Versus Anticoagulation Versus No Treatment
title Comparison of Non-Tumoral Portal Vein Thrombosis Management in Cirrhotic Patients: TIPS Versus Anticoagulation Versus No Treatment
title_full Comparison of Non-Tumoral Portal Vein Thrombosis Management in Cirrhotic Patients: TIPS Versus Anticoagulation Versus No Treatment
title_fullStr Comparison of Non-Tumoral Portal Vein Thrombosis Management in Cirrhotic Patients: TIPS Versus Anticoagulation Versus No Treatment
title_full_unstemmed Comparison of Non-Tumoral Portal Vein Thrombosis Management in Cirrhotic Patients: TIPS Versus Anticoagulation Versus No Treatment
title_short Comparison of Non-Tumoral Portal Vein Thrombosis Management in Cirrhotic Patients: TIPS Versus Anticoagulation Versus No Treatment
title_sort comparison of non-tumoral portal vein thrombosis management in cirrhotic patients: tips versus anticoagulation versus no treatment
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8198761/
https://www.ncbi.nlm.nih.gov/pubmed/34073236
http://dx.doi.org/10.3390/jcm10112316
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