Acute portal vein thrombosis unrelated to cirrhosis: a prospective multicenter follow-up study.

Détails

ID Serval
serval:BIB_8CD7FA51EFF1
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Acute portal vein thrombosis unrelated to cirrhosis: a prospective multicenter follow-up study.
Périodique
Hepatology
Auteur⸱e⸱s
Plessier A., Darwish-Murad S., Hernandez-Guerra M., Consigny Y., Fabris F., Trebicka J., Heller J., Morard I., Lasser L., Langlet P., Denninger M.H., Vidaud D., Condat B., Hadengue A., Primignani M., Garcia-Pagan J.C., Janssen H.L., Valla D.
Collaborateur⸱rice⸱s
European Network for Vascular Disorders of the Liver (EN-Vie)
Contributeur⸱rice⸱s
Bahr M., Elias E., Garcia-Pagan JC., Hadengue A., Janssen HL., Langlet P., Miranda H., Primignani M., Valla D., Adler M., Deltenre P., Orlent H., Colle I., Leebeek FW., Tielemans WC., Rijken DC., van Buuren H., Mensink P., de Man RA. , Malfliet JJ., Keizerwaard A., van Santen L., Hansen B., ten Hove W., van de Meeberg PC. , van der Werf S., Bac DJ., Adang RP., van Bergeijk J., Beukers R., van de Vrie W., Berk L., van Tilburg AJ. , Jansen PL., Poen AC., Drenth JP., Brouwer JT., Haagsma EB., Houben MH., Tjwa ET., van Esser JW. , Fontenelle D., Robin D., Pauwels A., Lemercier D., De Kerguenec C., Sondag L., Anslik T., Belghitti J., Cazals-Hatem D., Durand F., Vilgrain V., Buffet C., Goria O., Dao MT., Mallat A., Bartoli E., Habersetszer F., Scoazec JY., Mathurin P., Nousbaum JB., Chagneau-Derrode C., Marteau P., Thabut D., De Ledinghen V., Bureau C., Carbonel N., Bacq Y., Hillaire S., Rosenbaum A., Rössle M., Marra F., Vizzutti F., Berzigotti A., Zoli M., Boschetti C., Dell'Era A., Nicolini A., Bellis L., Puoti C., Minoli G., Spinzi G., De Santis A., Merli M., Riggio O., Abraldes JG., Berzigotti A., Ayuso JR., Cervantes F., Fuster J., Garcia-Criado A., Gilabert R., Lozano R., Reverter JC., Bosch J.
ISSN
1527-3350 (Electronic)
ISSN-L
0270-9139
Statut éditorial
Publié
Date de publication
2010
Volume
51
Numéro
1
Pages
210-218
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
Current recommendations for early anticoagulation in acute portal vein thrombosis unrelated to cirrhosis or malignancy are based on limited evidence. The aim of this study was to prospectively assess the risk factors, outcome, and prognosis in patients managed according to these recommendations. We enrolled 102 patients with acute thrombosis of the portal vein, or its left or right branch. Laboratory investigations for prothrombotic factors were centralized. Thrombus extension and recanalization were assessed by expert radiologists. A local risk factor was identified in 21% of patients, and one or several general prothrombotic conditions in 52%. Anticoagulation was given to 95 patients. After a median of 234 days, the portal vein and its left or right branch were patent in 39% of anticoagulated patients (versus 13% initially), the splenic vein in 80% (versus 57% initially), and the superior mesenteric vein in 73% (versus 42% initially). Failure to recanalize the portal vein was independently related to the presence of ascites (hazard ratio 3.8, 95% confidence interval 1.3-11.1) and an occluded splenic vein (hazard ratio 3.5, 95% confidence interval 1.4-8.9). Gastrointestinal bleeding and intestinal infarction occurred in nine and two patients, respectively. Two patients died from causes unrelated to thrombosis or anticoagulation therapy.
CONCLUSION: Recanalization occurs in one-third of patients receiving early anticoagulation for acute portal vein thrombosis, whereas thrombus extension, intestinal infarction, severe bleeding, and death are rare. Alternative therapy should be considered when ascites and splenic vein obstruction are present.
Mots-clé
Acute Disease, Adolescent, Adult, Aged, Aged, 80 and over, Anticoagulants/therapeutic use, Ascites/complications, Female, Follow-Up Studies, Humans, Liver Cirrhosis/complications, Male, Mesenteric Veins/radiography, Middle Aged, Portal Vein/radiography, Prospective Studies, Risk Factors, Splenic Vein/radiography, Treatment Outcome, Venous Thrombosis/drug therapy, Venous Thrombosis/etiology
Pubmed
Web of science
Open Access
Oui
Création de la notice
06/12/2013 10:11
Dernière modification de la notice
20/08/2019 14:51
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