Risk factors for portal venous thrombosis after splenectomy in patients with cirrhosis and portal hypertension

Kinjo, Nao; Kawanaka, Hirofumi; Akahoshi, Tomohiko; Tomikawa, Morimasa; Yamashita, Natsumi; Konishi, Kozo; Tanoue, Kazuo; Shirabe, Ken; Hashizume, Makoto; Maehara, Yoshihiko

doi:10.1002/bjs.7002

Cited by 115 publications

(90 citation statements)

References 33 publications

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“…Reduced portal flow velocity seems to be the most important predictive variable for PVT development in patients with cirrhosis [37][38][39] . Amitrano et al [38] suggested that portal blood stasis in patients with cirrhosis is the main change favoring thrombosis, even in the presence of other local, systemic, congenital and acquired factors.…”

Section: Etiology Of Pvt In Cirrhosismentioning

confidence: 97%

“…Amitrano et al [38] suggested that portal blood stasis in patients with cirrhosis is the main change favoring thrombosis, even in the presence of other local, systemic, congenital and acquired factors. Kinjo et al [39] performed Doppler ultrasonographic examinations after splenectomy in patients with cirrhosis and showed that portal venous flow was dramatically decreased by 49.2% in the PVT group but only by 6.6% in the non-PVT group.…”

Section: Etiology Of Pvt In Cirrhosismentioning

confidence: 99%

“…In addition, it can improve the prognosis for patients with cirrhosis by allowing them to receive interferon therapy or undergo treatment for HCC [44,45] . Despite the good results demonstrated in these studies, the high prevalence of PVT after splenectomy in patients with cirrhosis remains problematic [39,46] . It has been suggested that blood turbulence or stasis in the stump of the splenic vein after splenectomy might result in increased coagulability, leading to the propagation of splenic venous thrombus formation in the portal system after splenectomy [47] .…”

Section: Etiology Of Pvt In Cirrhosismentioning

confidence: 99%

“…It has been suggested that blood turbulence or stasis in the stump of the splenic vein after splenectomy might result in increased coagulability, leading to the propagation of splenic venous thrombus formation in the portal system after splenectomy [47] . Splenomegaly and a large splenic vein diameter are independent risk factors for PVT after splenectomy in patients with concomitant cirrhosis and portal hypertension [39,46,47] . The role of sclerotherapy as a potential trigger for PVT is controversial [48,49] .…”

Section: Etiology Of Pvt In Cirrhosismentioning

confidence: 99%

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Portal vein thrombosis in liver cirrhosis

Kinjo¹,

Kawanaka²,

Akahoshi³

et al. 2014

WJH

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Portal vein thrombosis (PVT) is considered to be a frequent complication of liver cirrhosis. However, unlike PVT in patients without cirrhosis, very few data are available on the natural history and management of PVT in cirrhosis, despite its association with potentially life-threatening conditions, such as gastroesophageal bleeding and acute intestinal ischemia. Moreover, no consensus regarding PVT in cirrhosis exists. Suggested causes of PVT in cirrhosis include reduced portal blood flow velocity, multiple congenital or acquired thrombophilic factors, inherited or acquired conditions, and derangement of liver architecture. However, the understanding of PVT in cirrhosis is incomplete. In addition, information on the management of PVT in cirrhosis is inadequate. The aims of this review are to: (1) assemble data on the physiopathological mechanism, clinical findings, diagnosis and management of PVT in cirrhosis; (2) describe the principal factors most frequently involved in PVT development; and (3) summarize the recent knowledge concerning diagnostic and therapeutic procedures.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Portal vein thrombosis; Liver cirrhosis; Thrombophilic factors; Anticoagulation; Splenectomy Core tip: Portal vein thrombosis (PVT) is considered to be a frequent complication of liver cirrhosis; however, very few data are available on the natural history and management of PVT in cirrhosis, despite its association with potentially life-threatening conditions. The understanding and information on the management of PVT in cirrhosis are incomplete. The aims of this review are to: (1) assemble data on the physiopathological mechanism, clinical findings, diagnosis and management of PVT in cirrhosis; (2) describe the principal factors most frequently involved in PVT development; and (3) summarize the recent knowledge concerning diagnostic and therapeutic procedures.

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Section: Etiology Of Pvt In Cirrhosismentioning

confidence: 97%

Section: Etiology Of Pvt In Cirrhosismentioning

confidence: 99%

Section: Etiology Of Pvt In Cirrhosismentioning

confidence: 99%

Section: Etiology Of Pvt In Cirrhosismentioning

confidence: 99%

See 2 more Smart Citations

Portal vein thrombosis in liver cirrhosis

Kinjo¹,

Kawanaka²,

Akahoshi³

et al. 2014

WJH

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“…Previous studies of PVST mainly focused on myelodysplastic syndromes (8)(9)(10), hemolytic anemia (8,9), spleen tumors (8), and traumatic splenic rupture (9). In recent years, it has been found that patients with cirrhosis and portal hypertension also have high risks of developing PVST after splenectomy (11). To date, the mechanism underlying PVST formation in these patients is still unclear, and the prophylactic application of anticoagulants is controversial because of the concerns about the risk of inducing bleeding (12,13).…”

Section: Introductionmentioning

confidence: 99%

The incidence and risk factors of portal vein system thrombosis after splenectomy and pericardial devascularization

Zheng²,

Zhang³

et al. 2015

Turk J Gastroenterol

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Background/Aims: This study aimed to investigate the incidence and risk factors of portal vein system thrombosis (PVST) in patients with liver cirrhosis after splenectomy and pericardial devascularization. Materials and Methods: We retrospectively analyzed 71 patients who underwent splenectomy with pericardial devascularization for portal hypertension due to cirrhosis. Patients were categorized into Group A (n=23): early prophylactic anticoagulants therapy; Group B (n=29): late prophylactic anticoagulants therapy; and Group C (n=19): no anticoagulation therapy. Univariate and multivariate analyses of the risk factors of PVST were performed. The incidence of PVST and the effect of thrombolytic therapy were evaluated. Results: Multivariate analysis revealed a wider preoperative splenic vein diameter (≥8 mm), and lower preoperative platelet counts (<50×10

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