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Digestive Disease Interventions 2020; 04(02): 122-133
DOI: 10.1055/s-0040-1712119
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of Portal and Mesenteric Venous Thrombosis

Joshua A. Turkeltaub 
1   Division of Gastroenterology and Hepatology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
,
Michael Kriss 
1   Division of Gastroenterology and Hepatology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
› Author Affiliations
Further Information

Publication History

20 January 2020

08 April 2020

Publication Date:
01 June 2020 (online)

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Abstract

Portal vein thrombosis is a rare condition seen in the general population, though is more prevalent in certain populations with thrombophilia as well as in patients with cirrhosis. Because morbidity and mortality can be significant with portal vein thrombosis, diagnosis and appropriate management are crucial. In noncirrhotic patients, untreated portal vein thrombosis can result in mesenteric ischemia and complications of portal hypertension. In cirrhosis, portal vein thrombosis is often incidentally found on routine screening imaging, and the treatment outside of transplant candidates is more controversial. In this review, we will outline risk factors for portal vein thrombosis, discuss indications for treatment, and evaluate both pharmacological and endovascular treatment options, highlighting unique clinical considerations dependent on the presence or absence of cirrhosis.

Keywords

portal vein thrombosis - mesenteric thrombosis - anticoagulation - cirrhosis - thrombophilia
 

  • References

  • 1 Conzen KD, Pomfret EA. Liver transplant in patients with portal vein thrombosis: medical and surgical requirements. Liver Transpl 2017; 23 (S1): S59-S63
    CrossrefPubMedGoogle Scholar
  • 2 European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu. EASL Clinical Practice Guidelines: vascular diseases of the liver. J Hepatol 2016; 64 (01) 179-202
    CrossrefPubMedGoogle Scholar
  • 3 Yerdel MA, Gunson B, Mirza D. , et al. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome. Transplantation 2000; 69 (09) 1873-1881
    CrossrefPubMedGoogle Scholar
  • 4 Stine JG, Northup PG. Management of non-tumoral portal vein thrombosis in patients with cirrhosis. Dig Dis Sci 2019; 64 (03) 619-626
    CrossrefPubMedGoogle Scholar
  • 5 Sarin SK, Philips CA, Kamath PS. , et al. Toward a comprehensive new classification of portal vein thrombosis in patients with cirrhosis. Gastroenterology 2016; 151 (04) 574-577.e3
    CrossrefPubMedGoogle Scholar
  • 6 Rajani R, Björnsson E, Bergquist A. , et al. The epidemiology and clinical features of portal vein thrombosis: a multicentre study. Aliment Pharmacol Ther 2010; 32 (09) 1154-1162
    CrossrefPubMedGoogle Scholar
  • 7 Ogren M, Bergqvist D, Björck M, Acosta S, Eriksson H, Sternby NH. Portal vein thrombosis: prevalence, patient characteristics and lifetime risk: a population study based on 23,796 consecutive autopsies. World J Gastroenterol 2006; 12 (13) 2115-2119
    CrossrefPubMedGoogle Scholar
  • 8 Middeldorp S, van Hylckama Vlieg A. Does thrombophilia testing help in the clinical management of patients?. Br J Haematol 2008; 143 (03) 321-335
    CrossrefPubMedGoogle Scholar
  • 9 Saugel B, Lee M, Feichtinger S, Hapfelmeier A, Schmid RM, Siveke JT. Thrombophilic factor analysis in cirrhotic patients with portal vein thrombosis. J Thromb Thrombolysis 2015; 40 (01) 54-60
    CrossrefPubMedGoogle Scholar
  • 10 Amitrano L, Brancaccio V, Guardascione MA. , et al. Inherited coagulation disorders in cirrhotic patients with portal vein thrombosis. Hepatology 2000; 31 (02) 345-348
    CrossrefPubMedGoogle Scholar
  • 11 Amitrano L, Guardascione MA, Brancaccio V. , et al. Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis. J Hepatol 2004; 40 (05) 736-741
    CrossrefPubMedGoogle Scholar
  • 12 Erkan O, Bozdayi AM, Disibeyaz S. , et al. Thrombophilic gene mutations in cirrhotic patients with portal vein thrombosis. Eur J Gastroenterol Hepatol 2005; 17 (03) 339-343
    CrossrefPubMedGoogle Scholar
  • 13 Smalberg JH, Kruip MJ, Janssen HL, Rijken DC, Leebeek FW, de Maat MP. Hypercoagulability and hypofibrinolysis and risk of deep vein thrombosis and splanchnic vein thrombosis: similarities and differences. Arterioscler Thromb Vasc Biol 2011; 31 (03) 485-493
    CrossrefPubMedGoogle Scholar
  • 14 Janssen HL, Meinardi JR, Vleggaar FP. , et al. Factor V Leiden mutation, prothrombin gene mutation, and deficiencies in coagulation inhibitors associated with Budd-Chiari syndrome and portal vein thrombosis: results of a case-control study. Blood 2000; 96 (07) 2364-2368
    PubMedGoogle Scholar
  • 15 Primignani M, Martinelli I, Bucciarelli P. , et al. Risk factors for thrombophilia in extrahepatic portal vein obstruction. Hepatology 2005; 41 (03) 603-608
    CrossrefPubMedGoogle Scholar
  • 16 DeLeve LD, Valla DC, Garcia-Tsao G. ; American Association for the Study Liver Diseases. Vascular disorders of the liver. Hepatology 2009; 49 (05) 1729-1764
    CrossrefPubMedGoogle Scholar
  • 17 Marchetti M, Castoldi E, Spronk HM. , et al. Thrombin generation and activated protein C resistance in patients with essential thrombocythemia and polycythemia vera. Blood 2008; 112 (10) 4061-4068
    PubMedGoogle Scholar
  • 18 Tripodi A, Chantarangkul V, Gianniello F. , et al. Global coagulation in myeloproliferative neoplasms. Ann Hematol 2013; 92 (12) 1633-1639
    CrossrefPubMedGoogle Scholar
  • 19 Kiladjian JJ, Cervantes F, Leebeek FW. , et al. The impact of JAK2 and MPL mutations on diagnosis and prognosis of splanchnic vein thrombosis: a report on 241 cases. Blood 2008; 111 (10) 4922-4929
    CrossrefPubMedGoogle Scholar
  • 20 De Stefano V, Fiorini A, Rossi E. , et al. Incidence of the JAK2 V617F mutation among patients with splanchnic or cerebral venous thrombosis and without overt chronic myeloproliferative disorders. J Thromb Haemost 2007; 5 (04) 708-714
    CrossrefPubMedGoogle Scholar
  • 21 Colaizzo D, Amitrano L, Tiscia GL. , et al. The JAK2 V617F mutation frequently occurs in patients with portal and mesenteric venous thrombosis. J Thromb Haemost 2007; 5 (01) 55-61
    PubMedGoogle Scholar
  • 22 Primignani M, Barosi G, Bergamaschi G. , et al. Role of the JAK2 mutation in the diagnosis of chronic myeloproliferative disorders in splanchnic vein thrombosis. Hepatology 2006; 44 (06) 1528-1534
    CrossrefPubMedGoogle Scholar
  • 23 Plessier A, Darwish-Murad S, Hernandez-Guerra M. , et al; European Network for Vascular Disorders of the Liver (EN-Vie). Acute portal vein thrombosis unrelated to cirrhosis: a prospective multicenter follow-up study. Hepatology 2010; 51 (01) 210-218
    CrossrefPubMedGoogle Scholar
  • 24 de Franchis R. ; Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol 2015; 63 (03) 743-752
    CrossrefPubMedGoogle Scholar
  • 25 Denninger MH, Chaït Y, Casadevall N. , et al. Cause of portal or hepatic venous thrombosis in adults: the role of multiple concurrent factors. Hepatology 2000; 31 (03) 587-591
    CrossrefPubMedGoogle Scholar
  • 26 Intagliata NM, Caldwell SH, Tripodi A. Diagnosis, development, and treatment of portal vein thrombosis in patients with and without cirrhosis. Gastroenterology 2019; 156 (06) 1582-1599.e1
    CrossrefPubMedGoogle Scholar
  • 27 Tessler FN, Gehring BJ, Gomes AS. , et al. Diagnosis of portal vein thrombosis: value of color Doppler imaging. AJR Am J Roentgenol 1991; 157 (02) 293-296
    CrossrefPubMedGoogle Scholar
  • 28 Bach AM, Hann LE, Brown KT. , et al. Portal vein evaluation with US: comparison to angiography combined with CT arterial portography. Radiology 1996; 201 (01) 149-154
    CrossrefPubMedGoogle Scholar
  • 29 Senzolo M, Riggio O, Primignani M. ; Italian Association for the Study of the Liver (AISF) ad hoc. Vascular disorders of the liver: recommendations from the Italian Association for the Study of the Liver (AISF) ad hoc committee. Dig Liver Dis 2011; 43 (07) 503-514
    CrossrefPubMedGoogle Scholar
  • 30 Rodríguez-Castro KI, Porte RJ, Nadal E, Germani G, Burra P, Senzolo M. Management of nonneoplastic portal vein thrombosis in the setting of liver transplantation: a systematic review. Transplantation 2012; 94 (11) 1145-1153
    PubMedGoogle Scholar
  • 31 Danila M, Sporea I, Popescu A, Șirli R. Portal vein thrombosis in liver cirrhosis - the added value of contrast enhanced ultrasonography. Med Ultrason 2016; 18 (02) 218-233
    CrossrefPubMedGoogle Scholar
  • 32 Margini C, Berzigotti A. Portal vein thrombosis: the role of imaging in the clinical setting. Dig Liver Dis 2017; 49 (02) 113-120
    CrossrefPubMedGoogle Scholar
  • 33 Amitrano L, Guardascione MA, Scaglione M. , et al. Prognostic factors in noncirrhotic patients with splanchnic vein thromboses. Am J Gastroenterol 2007; 102 (11) 2464-2470
    CrossrefPubMedGoogle Scholar
  • 34 Condat B, Pessione F, Helene Denninger M, Hillaire S, Valla D. Recent portal or mesenteric venous thrombosis: increased recognition and frequent recanalization on anticoagulant therapy. Hepatology 2000; 32 (03) 466-470
    CrossrefPubMedGoogle Scholar
  • 35 Sheen CL, Lamparelli H, Milne A, Green I, Ramage JK. Clinical features, diagnosis and outcome of acute portal vein thrombosis. QJM 2000; 93 (08) 531-534
    CrossrefPubMedGoogle Scholar
  • 36 Elkrief L, Corcos O, Bruno O. , et al. Type 2 diabetes mellitus as a risk factor for intestinal resection in patients with superior mesenteric vein thrombosis. Liver Int 2014; 34 (09) 1314-1321
    CrossrefPubMedGoogle Scholar
  • 37 Grendell JH, Ockner RK. Mesenteric venous thrombosis. Gastroenterology 1982; 82 (02) 358-372
    CrossrefPubMedGoogle Scholar
  • 38 Valla DC, Condat B. Portal vein thrombosis in adults: pathophysiology, pathogenesis and management. J Hepatol 2000; 32 (05) 865-871
    CrossrefPubMedGoogle Scholar
  • 39 Turnes J, García-Pagán JC, González M. , et al. Portal hypertension-related complications after acute portal vein thrombosis: impact of early anticoagulation. Clin Gastroenterol Hepatol 2008; 6 (12) 1412-1417
    CrossrefPubMedGoogle Scholar
  • 40 De Gaetano AM, Lafortune M, Patriquin H, De Franco A, Aubin B, Paradis K. Cavernous transformation of the portal vein: patterns of intrahepatic and splanchnic collateral circulation detected with Doppler sonography. AJR Am J Roentgenol 1995; 165 (05) 1151-1155
    CrossrefPubMedGoogle Scholar
  • 41 Condat B, Pessione F, Hillaire S. , et al. Current outcome of portal vein thrombosis in adults: risk and benefit of anticoagulant therapy. Gastroenterology 2001; 120 (02) 490-497
    CrossrefPubMedGoogle Scholar
  • 42 Orr DW, Harrison PM, Devlin J. , et al. Chronic mesenteric venous thrombosis: evaluation and determinants of survival during long-term follow-up. Clin Gastroenterol Hepatol 2007; 5 (01) 80-86
    CrossrefPubMedGoogle Scholar
  • 43 Gupta D, Vijaya DR, Gupta R. , et al. Prevalence of hepatopulmonary syndrome in cirrhosis and extrahepatic portal venous obstruction. Am J Gastroenterol 2001; 96 (12) 3395-3399
    CrossrefPubMedGoogle Scholar
  • 44 Plessier A, Rautou PE, Valla DC. Management of hepatic vascular diseases. J Hepatol 2012; 56 (Suppl. 01) S25-S38
    PubMedGoogle Scholar
  • 45 Kearon C, Akl EA, Comerota AJ. , et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2, Suppl): e419S-e496S
    CrossrefPubMedGoogle Scholar
  • 46 Spaander MC, Hoekstra J, Hansen BE, Van Buuren HR, Leebeek FW, Janssen HL. Anticoagulant therapy in patients with non-cirrhotic portal vein thrombosis: effect on new thrombotic events and gastrointestinal bleeding. J Thromb Haemost 2013; 11 (03) 452-459
    CrossrefPubMedGoogle Scholar
  • 47 Noronha Ferreira C, Seijo S, Plessier A. , et al. Natural history and management of esophagogastric varices in chronic noncirrhotic, nontumoral portal vein thrombosis. Hepatology 2016; 63 (05) 1640-1650
    CrossrefPubMedGoogle Scholar
  • 48 Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology 2017; 65 (01) 310-335
    CrossrefPubMedGoogle Scholar
  • 49 Condat B, Vilgrain V, Asselah T. , et al. Portal cavernoma-associated cholangiopathy: a clinical and MR cholangiography coupled with MR portography imaging study. Hepatology 2003; 37 (06) 1302-1308
    CrossrefPubMedGoogle Scholar
  • 50 Khuroo MS, Yattoo GN, Zargar SA. , et al. Biliary abnormalities associated with extrahepatic portal venous obstruction. Hepatology 1993; 17 (05) 807-813
    CrossrefPubMedGoogle Scholar
  • 51 Dhiman RK, Saraswat VA, Valla DC. , et al. Portal cavernoma cholangiopathy: consensus statement of a working party of the Indian national association for study of the liver. J Clin Exp Hepatol 2014; 4 (Suppl. 01) S2-S14
    PubMedGoogle Scholar
  • 52 Sharma AM, Zhu D, Henry Z. Portal vein thrombosis: when to treat and how?. Vasc Med 2016; 21 (01) 61-69
    CrossrefPubMedGoogle Scholar
  • 53 Agnelli G, Buller HR, Cohen A. , et al; AMPLIFY Investigators. Oral apixaban for the treatment of acute venous thromboembolism. N Engl J Med 2013; 369 (09) 799-808
    CrossrefPubMedGoogle Scholar
  • 54 Bauersachs R, Berkowitz SD, Brenner B. , et al; EINSTEIN Investigators. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med 2010; 363 (26) 2499-2510
    CrossrefPubMedGoogle Scholar
  • 55 Janczak DT, Mimier MK, McBane RD. , et al. Rivaroxaban and apixaban for initial treatment of acute venous thromboembolism of atypical location. Mayo Clin Proc 2018; 93 (01) 40-47
    CrossrefPubMedGoogle Scholar
  • 56 Francoz C, Belghiti J, Vilgrain V. , et al. Splanchnic vein thrombosis in candidates for liver transplantation: usefulness of screening and anticoagulation. Gut 2005; 54 (05) 691-697
    CrossrefPubMedGoogle Scholar
  • 57 Stine JG, Wang J, Shah PM. , et al. Decreased portal vein velocity is predictive of the development of portal vein thrombosis: a matched case-control study. Liver Int 2018; 38 (01) 94-101
    CrossrefPubMedGoogle Scholar
  • 58 Bartell N, Al-Judaibi B. The association between nonselective beta-blockers and portal venous thrombosis in cirrhotic patients: more questions on the horizon. Saudi J Gastroenterol 2018; 24 (01) 3-4
    CrossrefPubMedGoogle Scholar
  • 59 Violi F, Corazza GR, Caldwell SH. , et al; PRO-LIVER Collaborators. Portal vein thrombosis relevance on liver cirrhosis: Italian Venous Thrombotic Events Registry. Intern Emerg Med 2016; 11 (08) 1059-1066
    CrossrefPubMedGoogle Scholar
  • 60 Tripodi A, Mannucci PM. The coagulopathy of chronic liver disease. N Engl J Med 2011; 365 (02) 147-156
    CrossrefPubMedGoogle Scholar
  • 61 Tripodi A, Primignani M, Lemma L, Chantarangkul V, Mannucci PM. Evidence that low protein C contributes to the procoagulant imbalance in cirrhosis. J Hepatol 2013; 59 (02) 265-270
    CrossrefPubMedGoogle Scholar
  • 62 Sinegre T, Duron C, Lecompte T. , et al. Increased factor VIII plays a significant role in plasma hypercoagulability phenotype of patients with cirrhosis. J Thromb Haemost 2018; 16 (06) 1132-1140
    CrossrefPubMedGoogle Scholar
  • 63 O'Leary JG, Greenberg CS, Patton HM, Caldwell SH. AGA Clinical Practice Update: coagulation in cirrhosis. Gastroenterology 2019; 157 (01) 34-43.e1
    CrossrefPubMedGoogle Scholar
  • 64 Lisman T, Bongers TN, Adelmeijer J. , et al. Elevated levels of von Willebrand Factor in cirrhosis support platelet adhesion despite reduced functional capacity. Hepatology 2006; 44 (01) 53-61
    CrossrefPubMedGoogle Scholar
  • 65 Tublin ME, Dodd III GD, Baron RL. Benign and malignant portal vein thrombosis: differentiation by CT characteristics. AJR Am J Roentgenol 1997; 168 (03) 719-723
    CrossrefPubMedGoogle Scholar
  • 66 Sherman CB, Behr S, Dodge JL, Roberts JP, Yao FY, Mehta N. Distinguishing tumor from bland portal vein thrombus in liver transplant candidates with hepatocellular carcinoma: the A-VENA Criteria. Liver Transpl 2019; 25 (02) 207-216
    CrossrefPubMedGoogle Scholar
  • 67 Qi X, Guo X, Yoshida EM. , et al. Transient portal vein thrombosis in liver cirrhosis. BMC Med 2018; 16 (01) 83
    CrossrefPubMedGoogle Scholar
  • 68 Luca A, Caruso S, Milazzo M. , et al. Natural course of extrahepatic nonmalignant partial portal vein thrombosis in patients with cirrhosis. Radiology 2012; 265 (01) 124-132
    CrossrefPubMedGoogle Scholar
  • 69 Nery F, Chevret S, Condat B. , et al; Groupe d'Etude et de Traitement du Carcinome Hépatocellulaire. Causes and consequences of portal vein thrombosis in 1,243 patients with cirrhosis: results of a longitudinal study. Hepatology 2015; 61 (02) 660-667
    CrossrefPubMedGoogle Scholar
  • 70 Maruyama H, Okugawa H, Takahashi M, Yokosuka O. De novo portal vein thrombosis in virus-related cirrhosis: predictive factors and long-term outcomes. Am J Gastroenterol 2013; 108 (04) 568-574
    CrossrefPubMedGoogle Scholar
  • 71 Senzolo M, , M Sartori T, Rossetto V. , et al. Prospective evaluation of anticoagulation and transjugular intrahepatic portosystemic shunt for the management of portal vein thrombosis in cirrhosis. Liver Int 2012; 32 (06) 919-927
    CrossrefPubMedGoogle Scholar
  • 72 Stine JG, Pelletier SJ, Schmitt TM, Porte RJ, Northup PG. Pre-transplant portal vein thrombosis is an independent risk factor for graft loss due to hepatic artery thrombosis in liver transplant recipients. HPB (Oxford) 2016; 18 (03) 279-286
    CrossrefPubMedGoogle Scholar
  • 73 Francoz C, Valla D, Durand F. Portal vein thrombosis, cirrhosis, and liver transplantation. J Hepatol 2012; 57 (01) 203-212
    CrossrefPubMedGoogle Scholar
  • 74 Bezinover D, Iskandarani K, Chinchilli V. , et al. Autoimmune conditions are associated with perioperative thrombotic complications in liver transplant recipients: a UNOS database analysis. BMC Anesthesiol 2016; 16 (01) 26
    PubMedGoogle Scholar
  • 75 Ghabril M, Agarwal S, Lacerda M, Chalasani N, Kwo P, Tector AJ. Portal vein thrombosis is a risk factor for poor early outcomes after liver transplantation: analysis of risk factors and outcomes for portal vein thrombosis in waitlisted patients. Transplantation 2016; 100 (01) 126-133
    CrossrefPubMedGoogle Scholar
  • 76 Zanetto A, Rodriguez-Kastro KI, Germani G. , et al. Mortality in liver transplant recipients with portal vein thrombosis - an updated meta-analysis. Transpl Int 2018; 31 (12) 1318-1329
    CrossrefPubMedGoogle Scholar
  • 77 Englesbe MJ, Schaubel DE, Cai S, Guidinger MK, Merion RM. Portal vein thrombosis and liver transplant survival benefit. Liver Transpl 2010; 16 (08) 999-1005
    CrossrefPubMedGoogle Scholar
  • 78 Hibi T, Nishida S, Levi DM. , et al. When and why portal vein thrombosis matters in liver transplantation: a critical audit of 174 cases. Ann Surg 2014; 259 (04) 760-766
    CrossrefPubMedGoogle Scholar
  • 79 Werner KT, Sando S, Carey EJ. , et al. Portal vein thrombosis in patients with end stage liver disease awaiting liver transplantation: outcome of anticoagulation. Dig Dis Sci 2013; 58 (06) 1776-1780
    CrossrefPubMedGoogle Scholar
  • 80 Delgado MG, Seijo S, Yepes I. , et al. Efficacy and safety of anticoagulation on patients with cirrhosis and portal vein thrombosis. Clin Gastroenterol Hepatol 2012; 10 (07) 776-783
    CrossrefPubMedGoogle Scholar
  • 81 Loffredo L, Pastori D, Farcomeni A, Violi F. Effects of anticoagulants in patients with cirrhosis and portal vein thrombosis: a systematic review and meta-analysis. Gastroenterology 2017; 153 (02) 480-487.e1
    CrossrefPubMedGoogle Scholar
  • 82 Rodriguez-Castro KI, Vitale A, Fadin M. , et al. A prediction model for successful anticoagulation in cirrhotic portal vein thrombosis. Eur J Gastroenterol Hepatol 2019; 31 (01) 34-42
    CrossrefPubMedGoogle Scholar
  • 83 Stine JG, Shah PM, Cornella SL. , et al. Portal vein thrombosis, mortality and hepatic decompensation in patients with cirrhosis: a meta-analysis. World J Hepatol 2015; 7 (27) 2774-2780
    CrossrefPubMedGoogle Scholar
  • 84 Mancuso A. Management of portal vein thrombosis in cirrhosis: an update. Eur J Gastroenterol Hepatol 2016; 28 (07) 739-743
    CrossrefPubMedGoogle Scholar
  • 85 John BV, Konjeti R, Aggarwal A. , et al. Impact of untreated portal vein thrombosis on pre and post liver transplant outcomes in cirrhosis. Ann Hepatol 2013; 12 (06) 952-958
    CrossrefPubMedGoogle Scholar
  • 86 Villa E, Cammà C, Marietta M. , et al. Enoxaparin prevents portal vein thrombosis and liver decompensation in patients with advanced cirrhosis. Gastroenterology 2012; 143 (05) 1253-1260.e4
    CrossrefPubMedGoogle Scholar
  • 87 Amitrano L, Guardascione MA, Menchise A. , et al. Safety and efficacy of anticoagulation therapy with low molecular weight heparin for portal vein thrombosis in patients with liver cirrhosis. J Clin Gastroenterol 2010; 44 (06) 448-451
    CrossrefPubMedGoogle Scholar
  • 88 Garcia DA, Baglin TP, Weitz JI, Samama MM. Parenteral anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2, Suppl): e24S-e43S
    CrossrefPubMedGoogle Scholar
  • 89 Senzolo M, Rodriguez-Castro KI, Rossetto V. , et al. Increased anticoagulant response to low-molecular-weight heparin in plasma from patients with advanced cirrhosis. J Thromb Haemost 2012; 10 (09) 1823-1829
    CrossrefPubMedGoogle Scholar
  • 90 Cui SB, Shu RH, Yan SP. , et al. Efficacy and safety of anticoagulation therapy with different doses of enoxaparin for portal vein thrombosis in cirrhotic patients with hepatitis B. Eur J Gastroenterol Hepatol 2015; 27 (08) 914-919
    CrossrefPubMedGoogle Scholar
  • 91 Haas CE, Nelsen JL, Raghavendran K. , et al. Pharmacokinetics and pharmacodynamics of enoxaparin in multiple trauma patients. J Trauma 2005; 59 (06) 1336-1343 , discussion 1343–1344
    CrossrefPubMedGoogle Scholar
  • 92 Tripodi A, Anstee QM, Sogaard KK, Primignani M, Valla DC. Hypercoagulability in cirrhosis: causes and consequences. J Thromb Haemost 2011; 9 (09) 1713-1723
    CrossrefPubMedGoogle Scholar
  • 93 Kovacs MJ, Wong A, MacKinnon K. , et al. Assessment of the validity of the INR system for patients with liver impairment. Thromb Haemost 1994; 71 (06) 727-730
    Article in Thieme ConnectPubMedGoogle Scholar
  • 94 Hanafy AS, Abd-Elsalam S, Dawoud MM. Randomized controlled trial of rivaroxaban versus warfarin in the management of acute non-neoplastic portal vein thrombosis. Vascul Pharmacol 2019; 113: 86-91
    CrossrefPubMedGoogle Scholar
  • 95 Intagliata NM, Henry ZH, Maitland H. , et al. Direct oral anticoagulants in cirrhosis patients pose similar risks of bleeding when compared to traditional anticoagulation. Dig Dis Sci 2016; 61 (06) 1721-1727
    CrossrefPubMedGoogle Scholar
  • 96 Hum J, Shatzel JJ, Jou JH, Deloughery TG. The efficacy and safety of direct oral anticoagulants vs traditional anticoagulants in cirrhosis. Eur J Haematol 2017; 98 (04) 393-397
    CrossrefPubMedGoogle Scholar
  • 97 Nagaoki Y, Aikata H, Daijyo K. , et al. Efficacy and safety of edoxaban for treatment of portal vein thrombosis following danaparoid sodium in patients with liver cirrhosis. Hepatol Res 2018; 48 (01) 51-58
    CrossrefPubMedGoogle Scholar
  • 98 Liakoni E, Rätz Bravo AE, Terracciano L, Heim M, Krähenbühl S. Symptomatic hepatocellular liver injury with hyperbilirubinemia in two patients treated with rivaroxaban. JAMA Intern Med 2014; 174 (10) 1683-1686
    CrossrefPubMedGoogle Scholar
  • 99 Ueda M, Egawa H, Ogawa K. , et al. Portal vein complications in the long-term course after pediatric living donor liver transplantation. Transplant Proc 2005; 37 (02) 1138-1140
    CrossrefPubMedGoogle Scholar
  • 100 Khalaf H. Vascular complications after deceased and living donor liver transplantation: a single-center experience. Transplant Proc 2010; 42 (03) 865-870
    CrossrefPubMedGoogle Scholar
  • 101 Baccarani U, Gasparini D, Risaliti A. , et al. Percutaneous mechanical fragmentation and stent placement for the treatment of early posttransplantation portal vein thrombosis. Transplantation 2001; 72 (09) 1572-1582
    CrossrefPubMedGoogle Scholar
  • 102 Saad WE. Portal interventions in liver transplant recipients. Semin Intervent Radiol 2012; 29 (02) 99-104
    Article in Thieme ConnectPubMedGoogle Scholar
  • 103 Dumortier J, Czyglik O, Poncet G. , et al. Eversion thrombectomy for portal vein thrombosis during liver transplantation. Am J Transplant 2002; 2 (10) 934-938
    CrossrefPubMedGoogle Scholar
  • 104 Ganger DR, Klapman JB, McDonald V. , et al. Transjugular intrahepatic portosystemic shunt (TIPS) for Budd-Chiari syndrome or portal vein thrombosis: review of indications and problems. Am J Gastroenterol 1999; 94 (03) 603-608
    PubMedGoogle Scholar
  • 105 Cherqui D, Duvoux C, Rahmouni A. , et al. Orthotopic liver transplantation in the presence of partial or total portal vein thrombosis: problems in diagnosis and management. World J Surg 1993; 17 (05) 669-674
    CrossrefPubMedGoogle Scholar
  • 106 Cavallari A, Vivarelli M, Bellusci R, Jovine E, Mazziotti A, Rossi C. Treatment of vascular complications following liver transplantation: multidisciplinary approach. Hepatogastroenterology 2001; 48 (37) 179-183
    PubMedGoogle Scholar
  • 107 Settmacher U, Nüssler NC, Glanemann M. , et al. Venous complications after orthotopic liver transplantation. Clin Transplant 2000; 14 (03) 235-241
    CrossrefPubMedGoogle Scholar
  • 108 Sánchez-Bueno F, Hernández Q, Ramírez P. , et al. Vascular complications in a series of 300 orthotopic liver transplants. Transplant Proc 1999; 31 (06) 2409-2410
    CrossrefPubMedGoogle Scholar
  • 109 Cherukuri R, Haskal ZJ, Naji A, Shaked A. Percutaneous thrombolysis and stent placement for the treatment of portal vein thrombosis after liver transplantation: long-term follow-up. Transplantation 1998; 65 (08) 1124-1126
    CrossrefPubMedGoogle Scholar
  • 110 Glockner JF, Forauer AR. Vascular or ischemic complications after liver transplantation. AJR Am J Roentgenol 1999; 173 (04) 1055-1059
    CrossrefPubMedGoogle Scholar
  • 111 Millis JM, Seaman DS, Piper JB. , et al. Portal vein thrombosis and stenosis in pediatric liver transplantation. Transplantation 1996; 62 (06) 748-754
    CrossrefPubMedGoogle Scholar
  • 112 Bilbao JI, Rodriguez-Cabello J, Longo J, Zornoza G, Páramo J, Lecumberri FJ. Portal thrombosis: percutaneous transhepatic treatment with urokinase--a case report. Gastrointest Radiol 1989; 14 (04) 326-328
    CrossrefPubMedGoogle Scholar
  • 113 Ozkan U, Oğuzkurt L, Tercan F, Tokmak N. Percutaneous transhepatic thrombolysis in the treatment of acute portal venous thrombosis. Diagn Interv Radiol 2006; 12 (02) 105-107
    PubMedGoogle Scholar
  • 114 Rodrigues SG, Maurer MH, Baumgartner I, De Gottardi A, Berzigotti A. Imaging and minimally invasive endovascular therapy in the management of portal vein thrombosis. Abdom Radiol (NY) 2018; 43 (08) 1931-1946
    CrossrefPubMedGoogle Scholar
  • 115 Klinger C, Riecken B, Schmidt A. , et al. Transjugular local thrombolysis with/without TIPS in patients with acute non-cirrhotic, non-malignant portal vein thrombosis. Dig Liver Dis 2017; 49 (12) 1345-1352
    CrossrefPubMedGoogle Scholar
  • 116 Smalberg JH, Spaander MV, Jie KS. , et al. Risks and benefits of transcatheter thrombolytic therapy in patients with splanchnic venous thrombosis. Thromb Haemost 2008; 100 (06) 1084-1088
    Article in Thieme ConnectPubMedGoogle Scholar
  • 117 Ferro C, Rossi UG, Bovio G, Dahamane M, Centanaro M. Transjugular intrahepatic portosystemic shunt, mechanical aspiration thrombectomy, and direct thrombolysis in the treatment of acute portal and superior mesenteric vein thrombosis. Cardiovasc Intervent Radiol 2007; 30 (05) 1070-1074
    CrossrefPubMedGoogle Scholar
  • 118 Hollingshead M, Burke CT, Mauro MA, Weeks SM, Dixon RG, Jaques PF. Transcatheter thrombolytic therapy for acute mesenteric and portal vein thrombosis. J Vasc Interv Radiol 2005; 16 (05) 651-661
    CrossrefPubMedGoogle Scholar
  • 119 Luca A, Miraglia R, Caruso S. , et al. Short- and long-term effects of the transjugular intrahepatic portosystemic shunt on portal vein thrombosis in patients with cirrhosis. Gut 2011; 60 (06) 846-852
    CrossrefPubMedGoogle Scholar
  • 120 Valentin N, Korrapati P, Constantino J, Young A, Weisberg I. The role of transjugular intrahepatic portosystemic shunt in the management of portal vein thrombosis: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2018; 30 (10) 1187-1193
    CrossrefPubMedGoogle Scholar
  • 121 Thornburg B, Desai K, Hickey R. , et al. Pretransplantation portal vein recanalization and transjugular intrahepatic portosystemic shunt creation for chronic portal vein thrombosis: final analysis of a 61-patient cohort. J Vasc Interv Radiol 2017; 28 (12) 1714-1721.e2
    CrossrefPubMedGoogle Scholar
  • 122 Salem R, Vouche M, Baker T. , et al. Pretransplant portal vein recanalization-transjugular intrahepatic portosystemic shunt in patients with complete obliterative portal vein thrombosis. Transplantation 2015; 99 (11) 2347-2355
    CrossrefPubMedGoogle Scholar
  • 123 Qi X, Han G. Transjugular intrahepatic portosystemic shunt in the treatment of portal vein thrombosis: a critical review of literature. Hepatol Int 2012; 6 (03) 576-590
    CrossrefPubMedGoogle Scholar
  • 124 Simonetto DA, Singal AK, Garcia-Tsao G, Caldwell SH, Ahn J, Kamath PS. ACG Clinical Guideline: disorders of the hepatic and mesenteric circulation. Am J Gastroenterol 2020; 115 (01) 18-40
    CrossrefPubMedGoogle Scholar
  • 125 Dentali F, Squizzato A, Brivio L. , et al. JAK2V617F mutation for the early diagnosis of Ph- myeloproliferative neoplasms in patients with venous thromboembolism: a meta-analysis. Blood 2009; 113 (22) 5617-5623
    CrossrefPubMedGoogle Scholar