Transjugular Intrahepatic Portosystemic Shunt for Portal Cavernoma with Symptomatic Portal Hypertension in Non-cirrhotic Patients

Qi, Xingshun; Han, Guohong; Yin, Zhihua; He, Chuangye; Wang, Jianhong; Guo, Wengang; Niu, Jing; Zhang, Wei; Bai, Ming; Fan, Daiming

doi:10.1007/s10620-011-1975-5

Cited by 83 publications

(90 citation statements)

References 33 publications

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“…In addition, as for the cirrhotic patients undergoing transjugular intrahepatic portosystemic shunts for the management of variceal bleeding, a preexisting PVT was not associated with the risk of rebleeding. However, it should be noticeable that a transjugular intrahepatic portosystemic shunt becomes technically complex in the setting of complete PVT and even impossible when an occluded portal vein progresses into fibrotic cord [31,32]. Generally, these findings suggested that PVT should increase the risk of bleeding in liver cirrhosis in nearly all clinical conditions but after transjugular intrahepatic portosystemic shunt.…”

Section: Discussionmentioning

confidence: 99%

Association between portal vein thrombosis and risk of bleeding in liver cirrhosis: A systematic review of the literature

Ren

et al. 2015

Clinics and Research in Hepatology and Gastroenterology

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Section: Discussionmentioning

confidence: 99%

Association between portal vein thrombosis and risk of bleeding in liver cirrhosis: A systematic review of the literature

Ren

et al. 2015

Clinics and Research in Hepatology and Gastroenterology

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“…As described previously [5,13], PVT was diagnosed if there was a thrombus within the main portal vein, regardless of thrombus extension into the superior mesenteric vein or splenic vein. The extension of PVT was evaluated according to the imaging findings.…”

Section: Methodsmentioning

confidence: 99%

Thrombotic risk factors in Chinese nonmalignant and noncirrhotic patients with portal vein thrombosis

et al. 2015

European Journal of Gastroenterology &Amp; Hepatology

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MPNs are an important thrombotic risk factor in Chinese patients with PVT. However, the extreme rarity of paroxysmal nocturnal hemoglobinuria, anticardiolipin IgG antibodies, and factor V G1691A and factor II G20210A mutations has precluded any support for the implementation of routine screening for these thrombotic factors in such patients. Additional case-control studies should confirm the role of the MTHFR C677T mutation and hyperhomocysteinemia in the pathogenesis of PVT.

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“…167 In chronic PVT (portal cavernoma) TIPS placement has been successful in 35%-80%. [168][169][170][171] TIPS is unsuccessful if the lumen of thrombosed portal vein is not catheterizable and cavernomatous vein is not amenable to dilatation.…”

Section: Tipsmentioning

confidence: 99%

Portal Vein Thrombosis

Chawla

Bodh

2015

Journal of Clinical and Experimental Hepatology

151

147

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Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. ( J CLIN EXP HEPATOL 2015;5:22-40)

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Transjugular Intrahepatic Portosystemic Shunt for Portal Cavernoma with Symptomatic Portal Hypertension in Non-cirrhotic Patients

Abstract: TIPS procedures are feasible and safe in selected patients with portal cavernoma. Successful TIPS insertions may decrease the incidence of variceal rebleeding.

Cited by 83 publications

References 33 publications

Association between portal vein thrombosis and risk of bleeding in liver cirrhosis: A systematic review of the literature

Association between portal vein thrombosis and risk of bleeding in liver cirrhosis: A systematic review of the literature

Thrombotic risk factors in Chinese nonmalignant and noncirrhotic patients with portal vein thrombosis

Portal Vein Thrombosis

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