Clinical implications of different risk factor profiles in patients with mesenteric venous thrombosis and systemic venous thromboembolism: a population-based study

Salim, Saman; Zarrouk, Moncef; Elf, Johan; Gottsäter, Anders; Sveinsdóttir, Signý Vala; Svensson, Peter; Acosta, Stefan

doi:10.1007/s11239-019-01816-x

Cited by 8 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, when comparing the contemporary series from high-income versus low- to middle-income countries, there was no difference in bowel resection and 30-day mortality rate. Regarding long-term mortality, there was no difference between patients with MVT and systemic venous thromboembolism in a population-based study from Sweden ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Management of Acute Mesenteric Venous Thrombosis: A Systematic Review of Contemporary Studies

Acosta

Salim

2020

Scand J Surg

Self Cite

View full text Add to dashboard Cite

Background and Aims: Acute mesenteric venous thrombosis accounts for up to 20% of all patients with acute mesenteric ischemia in high-income countries. Acute mesenteric venous thrombosis is nowadays relatively more often diagnosed with intravenous contrast-enhanced computed tomography in the portal phase than at explorative laparotomy No high-quality comparative studies between anticoagulation alone, endovascular therapy, or surgery exists. The aim of the present systematic review was to offer a contemporary overview on management. Materials and Methods: Eleven relevant published original studies with series of at least ten patients were retrieved from a Pub Med search between 2015 and 2020 using the Medical Subject Heading term “mesenteric venous thrombosis.” Results: When MVT is diagnosed early, immediate anticoagulation with either unfractionated heparin or subcutaneous low-molecular-weight heparin should commence. Surgeons need to be aware of the importance to scrutinize the computed tomography images themselves for assessment of secondary intestinal abnormalities to mesenteric venous thrombosis and the risk of bowel resection and worse prognosis. Progression toward peritonitis is an indication for explorative laparotomy and assessment of bowel viability. Frank transmural small bowel necrosis should be resected and bowel anastomosis may be delayed for several days until second look. Meanwhile, intravenous full-dose unfractionated heparin should be given at the end of the first operation. Postoperative major intra-abdominal or gastrointestinal bleeding occurs rarely, but the heparin effect can instantaneously be reversed by protamine sulfate. Patients who do not improve during conservative therapy with anticoagulation alone but without developing peritonitis may be subjected to endovascular therapy in expert centers. When the patient’s intestinal function has recovered, with or without bowel resection, switch from parenteral unfractionated heparin or low-molecular-weight heparin therapy to oral anticoagulation can be performed. There is a trend that direct oral anticoagulants are increasingly used instead of vitamin K antagonists. Up to now, direct oral anticoagulants have been shown to be equally effective with the same rate of bleeding complications. Patients with no strong permanent trigger factor for mesenteric venous thrombosis such as intra-abdominal cancer should undergo blood screening for inherited and acquired thrombophilia. Conclusion: Early diagnosis with emergency computed tomography with intravenous contrast-enhancement and imaging in the portal phase and anticoagulation therapy is necessary to be able to have a succesful non-operative succesful course.

show abstract

Section: Discussionmentioning

confidence: 99%

Management of Acute Mesenteric Venous Thrombosis: A Systematic Review of Contemporary Studies

Acosta

Salim

2020

Scand J Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…The high mortality, with increased risk of intestinal infarction 45 and risk of recurrence 41 of MVT linked to thrombophilia, compared with overall mortality from MVT, makes it advisable to systematically screen these patients for thrombophilia and to consider lifelong anticoagulant therapy, especially in the absence of a reversible risk factor. 10 We consider personal or family history of peripheral venous thrombosis as a risk factor for MVT, especially in the absence of a known underlying disease, as reported in the literature. 37,46 Among the pathogenic mechanisms of MVT categorized by Zarrouk et al 5 as "local venous congestion," we found three patients with liver cirrhosis, a comorbidity with an obvious poor prognosis in our series, where 100% of patients died in the perioperative period.…”

Section: Breast Cancermentioning

confidence: 99%

“…37,46 Among the pathogenic mechanisms of MVT categorized by Zarrouk et al 5 as "local venous congestion," we found three patients with liver cirrhosis, a comorbidity with an obvious poor prognosis in our series, where 100% of patients died in the perioperative period. Patients with MVT have a different risk factor profile than patients with systemic thromboembolism, 10 showing a higher prevalence of cancer. Malignancy has long been Journal of Vascular Surgery: Venous and Lymphatic Disorders recognized as a risk factor for hypercoagulability and has been reported to be present in 4% to 16% of patients with acute MVT.…”

Section: Breast Cancermentioning

confidence: 99%

“…7 Hypercoagulability states, intra-abdominal inflammatory processes, trauma, cancer, portal hypertension, and cirrhosis are some of the risk factors for MVT. [8][9][10][11] Early diagnosis is difficult due to nonspecific clinical features and biomarkers. 12 Immediate anticoagulation is the cornerstone of treatment, 12 which can achieve recanalization greater than 80% and reduce mortality, 13,14 which ranges between 12% and 50%.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Hypercoagulability status, operative mortality, and long-term survival in patients operated on for mesenteric venous thrombosis

Acosta-Mérida

López

Suárez-Cabrera

et al. 2023

Journal of Vascular Surgery: Venous and Lymphatic Disorders

View full text Add to dashboard Cite

Venous thromboembolism in non-COVID-19 population during the pandemic: a nationwide multicenter retrospective survey

Qian¹,

Lyu

Zhu

et al. 2021

J Thromb Thrombolysis

View full text Add to dashboard Cite

Impact of pandemic on the incidence of venous thromboembolism (VTE) in non-COVID-19 patients is undetermined. Thus, a nationwide multicenter retrospective survey was conducted to evaluate the disease burden in non-COVID-19 population. This multi-center survey involved 94 hospitals from 24 provinces in the mainland of China, and collected data on non-COVID-19 patients admitted to the radiology departments due to VTE between January 24 and April 16, 2020. Baseline characteristics, VTE risk factors, clinical manifestations and the treatments were compared with those in the same period of 2019. 3,358 patients with VTE from 74 hospitals were included in this study (1,458 in 2020, 1,900 in 2019). Most aged ≥ 50 years (80.6% in the pandemic, 81.2% in 2019). The number of patients aged 30-39 years increased from 3.9% in 2019 period to 5.8% in the pandemic (p = 0.009). Among the VTE risk factors, the rate of decreased activity increased significantly in the pandemic, and was much higher than that in 2019 (30.7% vs 22.6%, p < 0.0001). Under the risk of decreased activity, patients with comorbidities chronic diseases, especially diabetes, showed significantly a higher incidence of VTE (30.4% vs 22.0%, p < 0.0001). In the pandemic period, fewer patients were treated with anticoagulation alone (33.5% vs 36.7%, p = 0.05), and more underwent inferior vena cava filter (IVCF) implantation, compared with those in 2019 (66.5% vs 63.2%, p = 0.046). The pandemic increased the VTE risk of decreased activity among the non-COVID-19 population. Patients with comorbidities, especially diabetes, have a significant higher risk of VTE during the pandemic. Keywords Coronavirus disease 2019 • Venous thromboembolism • Non-COVID-19 population • Risk factors • Decreased activity Highlights• The pandemic affected the risk factors of venous thromboembolism (VTE).• Decreased activity is the leading VTE risk factor among the non-COVID-19 population. • Patients with comorbidities, especially diabetes, showed a significant higher risk of VTE.

show abstract

Clinical implications of different risk factor profiles in patients with mesenteric venous thrombosis and systemic venous thromboembolism: a population-based study

Cited by 8 publications

References 20 publications

Management of Acute Mesenteric Venous Thrombosis: A Systematic Review of Contemporary Studies

Management of Acute Mesenteric Venous Thrombosis: A Systematic Review of Contemporary Studies

Hypercoagulability status, operative mortality, and long-term survival in patients operated on for mesenteric venous thrombosis

Venous thromboembolism in non-COVID-19 population during the pandemic: a nationwide multicenter retrospective survey

Contact Info

Product

Resources

About