Acute Portal Vein Thrombosis Unrelated to Cirrhosis: A Prospective Multicenter Follow-Up Study

• DOI: 10.1002/hep.23259
• Publication Date: 2009-08-31T16:14:45Z
• Authors: Aurelie Plessier; Sarwa Darwish-Murad; Manuel Hernandez-...; Yann Consigny; Federica Fabris; Jonel Trebicka; Jorg Heller; Isabelle Morard; Luc Lasser; Philippe Langlet; Marie-Hélène Denn...; Dominique Vidaud; Bertrand Condat; Antoine Hadengue; Massimo Primignani; Juan-Carlos Garci...; Harry L. A. Janssen; Dominique Valla
• Keywords: Portal vein thrombosis

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 prospectively assess the risk factors, outcome, and prognosis patients managed according these recommendations. We enrolled 102 with vein, its left right branch. Laboratory investigations prothrombotic factors were centralized. Thrombus extension recanalization assessed by expert radiologists. A local factor identified 21% patients, one several general conditions 52%. Anticoagulation given 95 patients. After a median 234 days, branch patent 39% anticoagulated (versus 13% initially), splenic 80% 57% superior mesenteric 73% 42% initially). Failure recanalize independently related presence ascites (hazard ratio 3.8, 95% confidence interval 1.3-11.1) an occluded 3.5, 1.4–8.9). Gastrointestinal bleeding intestinal infarction occurred nine two respectively. Two died from causes therapy. Conclusion: Recanalization occurs one-third receiving thrombosis, whereas thrombus extension, infarction, severe bleeding, death rare. Alternative therapy should be considered when obstruction present. (Hepatology 2009.)