{"corpus_id":57439666,"paper_sha":"606f2b860402b61635a065a6a5056d6e76b824bc","doi":"10.1016/J.CLINRE.2018.11.011","arxiv_id":null,"pmid":30578107,"pmcid":null,"mag_id":2905291587,"dblp_id":null,"acl_id":null,"title":"Portal vein thrombosis and liver cirrhosis: Long-term anticoagulation is effective and safe.","year":2019,"publication_date":"2019-08-01","venue":"Clinics And Research in Hepatology and Gastroenterology","journal":{"name":"Clinics and research in hepatology and gastroenterology","pages":null,"volume":null},"journal_issn":null,"journal_title":null,"publication_types":["JournalArticle"],"pubmed_pub_types":["Journal Article"],"s2_fields_of_study":["Medicine"],"reference_count":25,"citation_count":18,"influential_citation_count":0,"is_open_access":true,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":[{"d":"Anticoagulants","mj":false,"qs":[{"q":"adverse effects","mj":false,"ui":"Q000009"},{"q":"therapeutic use","mj":true,"ui":"Q000627"}],"ui":"D000925"},{"d":"Female","mj":false,"ui":"D005260"},{"d":"Fibrinolytic Agents","mj":false,"qs":[{"q":"adverse effects","mj":false,"ui":"Q000009"},{"q":"therapeutic use","mj":false,"ui":"Q000627"}],"ui":"D005343"},{"d":"Follow-Up Studies","mj":false,"ui":"D005500"},{"d":"Hemorrhage","mj":false,"qs":[{"q":"chemically induced","mj":false,"ui":"Q000139"}],"ui":"D006470"},{"d":"Heparin, Low-Molecular-Weight","mj":false,"qs":[{"q":"adverse effects","mj":false,"ui":"Q000009"},{"q":"therapeutic use","mj":true,"ui":"Q000627"}],"ui":"D006495"},{"d":"Humans","mj":false,"ui":"D006801"},{"d":"Hypertension, Portal","mj":false,"qs":[{"q":"complications","mj":false,"ui":"Q000150"}],"ui":"D006975"},{"d":"Liver Cirrhosis","mj":false,"qs":[{"q":"complications","mj":true,"ui":"Q000150"},{"q":"surgery","mj":false,"ui":"Q000601"}],"ui":"D008103"},{"d":"Liver Transplantation","mj":false,"qs":[{"q":"statistics & numerical data","mj":false,"ui":"Q000706"}],"ui":"D016031"},{"d":"Male","mj":false,"ui":"D008297"},{"d":"Middle Aged","mj":false,"ui":"D008875"},{"d":"Portal Vein","mj":true,"ui":"D011169"},{"d":"Recurrence","mj":false,"ui":"D012008"},{"d":"Retrospective Studies","mj":false,"ui":"D012189"},{"d":"Treatment Outcome","mj":false,"ui":"D016896"},{"d":"Venous Thrombosis","mj":false,"qs":[{"q":"diagnostic imaging","mj":false,"ui":"Q000000981"},{"q":"drug therapy","mj":true,"ui":"Q000188"},{"q":"etiology","mj":false,"ui":"Q000209"}],"ui":"D020246"},{"d":"Withholding Treatment","mj":false,"ui":"D028761"}],"chemicals":[{"n":"Anticoagulants","ui":"D000925","reg":"0"},{"n":"Fibrinolytic Agents","ui":"D005343","reg":"0"},{"n":"Heparin, Low-Molecular-Weight","ui":"D006495","reg":"0"}],"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":"https://www.sciencedirect.com/science/article/am/pii/S2210740118302687","s2_open_access_landing_url":"https://www.semanticscholar.org/paper/606f2b860402b61635a065a6a5056d6e76b824bc","s2_open_access_license":"publisher-specific-oa","s2_open_access_status":"BRONZE","pmc_open_access_pdf_url":null,"pmc_open_access_landing_url":null,"pmc_open_access_license":null,"pmc_open_access_status":null,"unpaywall_open_access_pdf_url":null,"unpaywall_open_access_landing_url":null,"unpaywall_open_access_license":null,"unpaywall_open_access_status":null,"abstract":"BACKGROUND AND AIMS\nPortal vein thrombosis (PVT) is a common complication of liver cirrhosis. Anticoagulation therapy is efficient, but is associated with potentially severe side-effects, especially bleeding episodes. It is therefore still unclear which patients will benefit from anticoagulation, and for what duration. The aim of the present study was to retrospectively analyse our single centre experience on long-term anticoagulation in patients presenting a PVT, complicating cirrhosis.\n\n\nMETHODS\nData of 40 cirrhotic patients with PVT treated by anticoagulation therapy from June 2003 to May 2018 were collected. Regular imaging was performed to monitor the outcome of PVT. The hemorrhagic complications and the recurrence of the PVT after anticoagulation withdrawal were also analyzed.\n\n\nRESULTS\nThe median follow-up under anticoagulation therapy was 33.7 months. Complete (57.5%) or partial (25.0%) recanalization of PVT was observed. Fifteen bleeding episodes (37.5%) occurred in our population, related to portal hypertension in 7 (46.7%). Eleven (73.3%) patients required hospitalization and eight (53.3%) required blood transfusion. No patient died from bleeding complication. Anticoagulation was stopped in 10 patients (25.0%), because of regression of PVT in 5 patients or a haemorrhagic episode in 5 patients. Among those 10 patients, 7 had a recurrence or extension of the initial PVT.\n\n\nCONCLUSIONS\nOur results confirm that anticoagulation allows a recanalization of PVT complicating cirrhosis in the majority of the cases, is associated with non-severe bleeding complications, and can be maintained for a long duration in order to avoid recurrence.","claims":[{"public_id":"cl_e43ba51e873f1059162f07e609b05241","status":"active","text":"Among 10 patients who stopped anticoagulation (due to PVT regression in 5 or hemorrhage in 5), 7 had recurrence or extension of the initial portal vein thrombosis.","confidence":0.95,"contributors":[{"id":32,"public_id":"7c402c1b98","public_label":"뀨 (7c402c1b98)","roles":["extraction"],"url":"https://sah.borca.ai/u/7c402c1b98"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"},{"id":1165,"public_id":"ezd9qvkvax","public_label":"The Reverser‮ 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(ezd9qvkvax)","roles":["review"],"url":"https://sah.borca.ai/u/ezd9qvkvax"},{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["review"],"url":"https://sah.borca.ai/u/322360f1c1"}],"url":"https://sah.borca.ai/claims/cl_290064bdbb7bf6e8b62d3273c82164bd"},{"public_id":"cl_bf342e5fdf0a2ef89671b441d188c6ab","status":"active","text":"Bleeding episodes occurred in 37.5% of the population, with 46.7% related to portal hypertension; 73.3% required hospitalization and 53.3% required blood transfusion, but no patient died from bleeding.","confidence":0.95,"contributors":[{"id":32,"public_id":"7c402c1b98","public_label":"뀨 (7c402c1b98)","roles":["extraction"],"url":"https://sah.borca.ai/u/7c402c1b98"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"},{"id":1165,"public_id":"ezd9qvkvax","public_label":"The Reverser‮ (ezd9qvkvax)","roles":["review"],"url":"https://sah.borca.ai/u/ezd9qvkvax"},{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["review"],"url":"https://sah.borca.ai/u/322360f1c1"}],"url":"https://sah.borca.ai/claims/cl_bf342e5fdf0a2ef89671b441d188c6ab"},{"public_id":"cl_c1f812f4f629815150292dd14edabfeb","status":"active","text":"Long-term anticoagulation (median follow-up 33.7 months) is effective for recanalization and can be maintained to avoid recurrence of portal vein thrombosis in cirrhotic patients.","confidence":0.9,"contributors":[{"id":32,"public_id":"7c402c1b98","public_label":"뀨 (7c402c1b98)","roles":["extraction"],"url":"https://sah.borca.ai/u/7c402c1b98"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"},{"id":1165,"public_id":"ezd9qvkvax","public_label":"The Reverser‮ 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