Anticoagulation for the Treatment of Portal Vein Thrombosis in Cirrhosis: A Systematic Review and Meta-Analysis of Comparative Studies

Yao, Calvin; Zhao, Mangzhu; Ibrahim, Brittney; Saab, Sammy

doi:10.1016/j.jceh.2022.12.016

Cited by 6 publications

(5 citation statements)

References 48 publications

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“…Recently, Yao et al accomplished a systematic review and meta-analysis of 16 studies (1126 patients) examining the role of anticoagulation in PVT treatment [ 93 ]. Anticoagulation was related to PVT improvement (OR 3.64; 95% CI 2.56–5.17), PVT recanalization (OR 3.73; 95% CI 2.45–5.68), decreased PVT progression (OR 0.38; 95% CI 0.23–0.63), and decreased all-cause mortality (OR 0.47; 95% CI 0.29–0.75) [ 93 ]. Notably, the use of anticoagulation was not associated with bleeding events (OR 0.80; 95% CI 0.39–1.66) [ 93 ].…”

Section: Pvt Therapymentioning

confidence: 99%

“…Anticoagulation was related to PVT improvement (OR 3.64; 95% CI 2.56–5.17), PVT recanalization (OR 3.73; 95% CI 2.45–5.68), decreased PVT progression (OR 0.38; 95% CI 0.23–0.63), and decreased all-cause mortality (OR 0.47; 95% CI 0.29–0.75) [ 93 ]. Notably, the use of anticoagulation was not associated with bleeding events (OR 0.80; 95% CI 0.39–1.66) [ 93 ].…”

Section: Pvt Therapymentioning

confidence: 99%

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Portal Vein Thrombosis: State-of-the-Art Review

Boccatonda,

Gentilini,

Zanata

et al. 2024

JCM

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Background: Portal vein thrombosis (PVT) is a rare disease with an estimated incidence of 2 to 4 cases per 100,000 inhabitants. The most common predisposing conditions for PVT are chronic liver diseases (cirrhosis), primary or secondary hepatobiliary malignancy, major infectious or inflammatory abdominal disease, or myeloproliferative disorders. Methods: PVT can be classified on the basis of the anatomical site, the degree of venous occlusion, and the timing and type of presentation. The main differential diagnosis of PVT, both acute and chronic, is malignant portal vein invasion, most frequently by hepatocarcinoma, or constriction (typically by pancreatic cancer or cholangiocarcinoma). Results: The management of PVT is based on anticoagulation and the treatment of predisposing conditions. The aim of anticoagulation in acute thrombosis is to prevent the extension of the clot and enable the recanalization of the vein to avoid the development of complications, such as intestinal infarction and portal hypertension. Conclusions: The treatment with anticoagulant therapy favors the reduction of portal hypertension, and this allows for a decrease in the risk of bleeding, especially in patients with esophageal varices. The anticoagulant treatment is generally recommended for at least three to six months. Prosecution of anticoagulation is advised until recanalization or lifelong if the patient has an underlying permanent pro-coagulant condition that cannot be corrected or if there is thrombosis extending to the mesenteric veins.

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Section: Pvt Therapymentioning

confidence: 99%

Section: Pvt Therapymentioning

confidence: 99%

Portal Vein Thrombosis: State-of-the-Art Review

Boccatonda,

Gentilini,

Zanata

et al. 2024

JCM

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“…However, the conversion efficiency of PV technology drops as the temperature of the cells rises. To address this limitation of photovoltaic systems, researchers have introduced a new technology known as photovoltaic-thermal (PVT) integration to enhance the efficiency of solar energy usage [13]. PVT harnesses solar energy for both electricity generation and thermal energy to accomplish full solar energy utilization.…”

Section: Introductionmentioning

confidence: 99%

Numerical Investigation of Innovative Photovoltaic–Thermal (PVT) Collector Designs for Electrical and Thermal Enhancement

Wang,

Hou,

Taherian

et al. 2024

Energies

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Photovoltaic–thermal (PVT) technology is gaining popularity due to the diminishing availability of traditional fossil fuels and escalating environmental concerns. Enhancing the heat dissipation of PVT to improve its electrical and thermal performance remains a significant task. This study simulates the thermodynamic and heat transfer characteristics in multiple novel PVT structures by examining the impact of various factors such as collector materials, radiation intensity, mass flow rate, and inlet temperature. This work also identifies the optimal mass flow rate for locations with different solar radiation. The numerical results indicate that the electrical efficiency of a designed cylindrical structure has increased by 1.73% while the thermal efficiency has increased by 8.29%. Aluminum is identified as the most cost-effective material for the collector. The optimal mass flow rates in selected locations of Xining, Taiyuan, and Turpan are 0.36 kg/s, 0.35 kg/s, and 0.30 kg/s, respectively. The numerical results provide valuable insight into optimizing the design and operating conditions of PVT systems.

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“…Also, PVT has a definite negative effect on the outcome of liver transplantation (LT). A pre‐transplant PVT has been shown to increase the risk of graft failure, mortality, and PVT in the post‐LT period 7 . But, the majority of PVT in patients with cirrhosis are asymptomatic.…”

Section: Introductionmentioning

confidence: 99%

“…A pre-transplant PVT has been shown to increase the risk of graft failure, mortality, and PVT in the post-LT period. 7 But, the majority of PVT in patients with cirrhosis are asymptomatic. Hence, identifying the risk factors associated with the development of PVT in cirrhosis will help keep a close watch on these patients for early identification and treatment of PVT to improve the outcomes.…”

mentioning

confidence: 99%

Assessment of portal system hemodynamics for the prediction of portal vein thrombosis in cirrhosis—A systematic review and meta‐analysis

Giri

Singh

Kolhe

et al. 2023

J of Clinical Ultrasound

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BackgroundThe pathogenesis of portal vein thrombosis (PVT) in cirrhosis is multifactorial, with altered hemodynamics being proposed as a possible contributor. The present systematic review was conducted to study the role of assessment of portal hemodynamics for the prediction of PVT in patients with cirrhosis.MethodsThree databases (Medline, Embase, and Scopus) were searched from inception to February 2023 for studies comparing portal venous system parameters in patients with cirrhosis developing PVT with those not. Results were presented as mean difference (MD) or odds ratio (OR) with their 95% confidence intervals (CIs).ResultsA total of 31 studies (patients with cirrhosis: 19 studies, patients with cirrhosis undergoing splenectomy: 12 studies) were included. On pooling the data from multivariable analyses of the included studies, a larger portal vein diameter was a significant predictor of PVT in patients with cirrhosis without or with splenectomy with OR 1.74 (1.12–2.69) and OR 1.55 (1.26–1.92), respectively. On the other hand, a lower portal vein velocity (PVV) was a significant predictor of PVT in cirrhotics without or with splenectomy with OR 0.93 (0.91–0.96) and OR 0.71 (0.61–0.83), respectively. A PVV of <15 cm/s was the most commonly used cut‐off for the prediction of PVT. Patients developing PVT also had a significantly higher splenic length, thickness, and splenic vein velocity.ConclusionThe assessment of portal hemodynamic parameters at baseline evaluation in patients with cirrhosis may predict the development of PVT. Further studies are required to determine the optimal cut‐offs for various parameters.

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Anticoagulation for the Treatment of Portal Vein Thrombosis in Cirrhosis: A Systematic Review and Meta-Analysis of Comparative Studies

Cited by 6 publications

References 48 publications

Portal Vein Thrombosis: State-of-the-Art Review

Portal Vein Thrombosis: State-of-the-Art Review

Numerical Investigation of Innovative Photovoltaic–Thermal (PVT) Collector Designs for Electrical and Thermal Enhancement

Assessment of portal system hemodynamics for the prediction of portal vein thrombosis in cirrhosis—A systematic review and meta‐analysis

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