Michel Bergère1, Domitille Erard-Poinsot2, Olivier Boillot2, Pierre-Jean Valette1, Olivier Guillaud1, Christine Chambon-Augoyard1, Jérôme Dumortier3. 1. Fédération des spécialités digestives, hôpital Edouard-Herriot, hospices civils de Lyn, 69437 Lyon, France. 2. Fédération des spécialités digestives, hôpital Edouard-Herriot, hospices civils de Lyn, 69437 Lyon, France; Université Claude-Bernard Lyon 1, 69008 Lyon, France. 3. Fédération des spécialités digestives, hôpital Edouard-Herriot, hospices civils de Lyn, 69437 Lyon, France; Université Claude-Bernard Lyon 1, 69008 Lyon, France. Electronic address: jerome.dumortier@chu-lyon.fr.
Abstract
BACKGROUND AND AIMS: Portal vein thrombosis (PVT) is a common complication of liver cirrhosis. Anticoagulation therapy is efficient, but is associated with potentially severe side-effects, especially bleeding episodes. It is therefore still unclear which patients will benefit from anticoagulation, and for what duration. The aim of the present study was to retrospectively analyse our single centre experience on long-term anticoagulation in patients presenting a PVT, complicating cirrhosis. METHODS: Data of 40 cirrhotic patients with PVT treated by anticoagulation therapy from June 2003 to May 2018 were collected. Regular imaging was performed to monitor the outcome of PVT. The hemorrhagic complications and the recurrence of the PVT after anticoagulation withdrawal were also analyzed. RESULTS: The median follow-up under anticoagulation therapy was 33.7 months. Complete (57.5%) or partial (25.0%) recanalization of PVT was observed. Fifteen bleeding episodes (37.5%) occurred in our population, related to portal hypertension in 7 (46.7%). Eleven (73.3%) patients required hospitalization and eight (53.3%) required blood transfusion. No patient died from bleeding complication. Anticoagulation was stopped in 10 patients (25.0%), because of regression of PVT in 5 patients or a haemorrhagic episode in 5 patients. Among those 10 patients, 7 had a recurrence or extension of the initial PVT. CONCLUSIONS: Our results confirm that anticoagulation allows a recanalization of PVT complicating cirrhosis in the majority of the cases, is associated with non-severe bleeding complications, and can be maintained for a long duration in order to avoid recurrence.
BACKGROUND AND AIMS: Portal vein thrombosis (PVT) is a common complication of liver cirrhosis. Anticoagulation therapy is efficient, but is associated with potentially severe side-effects, especially bleeding episodes. It is therefore still unclear which patients will benefit from anticoagulation, and for what duration. The aim of the present study was to retrospectively analyse our single centre experience on long-term anticoagulation in patients presenting a PVT, complicating cirrhosis. METHODS: Data of 40 cirrhotic patients with PVT treated by anticoagulation therapy from June 2003 to May 2018 were collected. Regular imaging was performed to monitor the outcome of PVT. The hemorrhagic complications and the recurrence of the PVT after anticoagulation withdrawal were also analyzed. RESULTS: The median follow-up under anticoagulation therapy was 33.7 months. Complete (57.5%) or partial (25.0%) recanalization of PVT was observed. Fifteen bleeding episodes (37.5%) occurred in our population, related to portal hypertension in 7 (46.7%). Eleven (73.3%) patients required hospitalization and eight (53.3%) required blood transfusion. No patient died from bleeding complication. Anticoagulation was stopped in 10 patients (25.0%), because of regression of PVT in 5 patients or a haemorrhagic episode in 5 patients. Among those 10 patients, 7 had a recurrence or extension of the initial PVT. CONCLUSIONS: Our results confirm that anticoagulation allows a recanalization of PVT complicating cirrhosis in the majority of the cases, is associated with non-severe bleeding complications, and can be maintained for a long duration in order to avoid recurrence.
Authors: Cheng Han Ng; Darren Jun Hao Tan; Kameswara Rishi Yeshayahu Nistala; Nicholas Syn; Jieling Xiao; Eunice Xiang Xuan Tan; Felicia Zuying Woo; Nicholas W S Chew; Daniel Q Huang; Yock Young Dan; Arun J Sanyal; Mark D Muthiah Journal: Hepatol Int Date: 2021-08-21 Impact factor: 9.029