Portal vein thrombosis: What surgeons need to know

Quarrie, Ricardo; Stawicki, Stanislaw P.

doi:10.4103/ijciis.ijciis_71_17

Cited by 25 publications

(2 citation statements)

References 24 publications

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“…Surgical thrombectomy for PVT is generally challenging and is linked to substantial morbidity, but it can be indicated if anticoagulation or minimally invasive EVTs are unsuccessful [67]. If the thrombus is new and is confined to the SMV, which is relatively rare, surgical thrombectomy may be accomplished.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Endovascular Treatment for Acute Portal Vein Thrombosis

Ueda,

Saito,

Shirai

et al. 2024

Interventional Radiology

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Acute portal vein thrombosis is characterized by nonspecific abdominal pain, causing severe morbidity and mortality. Prompt diagnosis is crucial to avoid short-term complications such as intestinal infarction, sepsis, and death. The therapeutic goal is to prevent thrombus extension into the mesenteric veins and intestinal ischemia complications. Systemic anticoagulation is the standard treatment. However, endovascular treatments such as thrombolysis, thrombectomy, balloon angioplasty, stent placement, and transjugular intrahepatic portosystemic shunt placement have been performed in patients who are refractory to anticoagulation therapy or at a high risk of intestinal ischemia. This review discusses the clinical and diagnostic considerations in acute portal vein thrombosis, focusing on current endovascular treatments that are effective and safe. However, prospective data are required to compare endovascular treatment techniques and assess their outcomes.

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Section: Surgical Treatmentmentioning

confidence: 99%

Endovascular Treatment for Acute Portal Vein Thrombosis

Ueda,

Saito,

Shirai

et al. 2024

Interventional Radiology

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“…Portal vein thrombosis can be associated with increased risk of thrombotic and hemorrhagic complications ranging from. There are many well known risk factors of portal vein thrombosis including but not limited to, myeloproliferative neoplasm, in ammatory conditions of abdomen (acute appendicitis, acute diverticulitis, and acute pancreatitis), intra-abdominal malignancy, and intra-abdominal surgery [3]. Portal vein thrombosis Gill et al found that a standard deviation increase in ferritin was associated with signi cantly increased risk of venous thromboembolism with OR of 1.92 [4].…”

Section: Introductionmentioning

confidence: 99%

Association of hereditary hemochromatosis with portal vein thrombosis: A national inpatient sample (2016-2020) analysis

Kharel,

Pokhrel,

Kharel

et al. 2024

Preprint

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Hereditary hemochromatosis is a common inherited metabolic disorder of iron metabolism with variable penetrance. Portal vein thrombosis has several well-known causes including cirrhosis, myeloproliferative neoplasm, inflammatory conditions of abdomen (acute appendicitis, acute diverticulitis, and acute pancreatitis), intra-abdominal malignancy, intra-abdominal surgery, and thrombophilia. It is unknown whether hereditary hemochromatosis is associated with portal vein thrombosis. A retrospective analysis of the NIS database from 2016 to 2020 was conducted using International Classification of Diseases (ICD-10) codes to identify hospitalizations with portal vein thrombosis. We used Fischer's exact test to compare proportions and the student's t-test to compare continuous variables. We used multivariate regression analysis to calculate the adjusted odds ratio after controlling for age, gender, primary payer, Charlson Comorbidity index, cirrhosis, myeloproliferative neoplasm, inflammatory conditions of abdomen (acute appendicitis, acute diverticulitis, and acute pancreatitis), intra-abdominal malignancy, intra-abdominal surgery, history of past thrombosis, thrombophilia, end stage renal disease, obesity, smoking, and hyperlipidemia.There were 25805 hospitalizations with primary diagnosis of portal vein thrombosis. Multivariate logistic regression showed that hereditary hemochromatosis was independently associated with portal vein thrombosis (OR = 4.7, 95% CI = 1.15 to 19.35, p-value = 0.03) along with cirrhosis, myeloproliferative neoplasm, inflammatory conditions of abdomen, intra-abdominal malignancy, history of thrombosis, history of abdominal surgery, history of thrombophilia, and end stage renal disease among other factors.

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