Efficacy and safety of anticoagulation therapy with different doses of enoxaparin for portal vein thrombosis in cirrhotic patients with hepatitis B

2015 ◽  
Vol 27 (8) ◽  
pp. 914-919 ◽  
Author(s):  
Shao-bo Cui ◽  
Rong-hua Shu ◽  
Shi-ping Yan ◽  
Hao Wu ◽  
Yong Chen ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Anticoagulation Therapy ◽  
Efficacy And Safety ◽  
Vein Thrombosis ◽  
Cirrhotic Patients ◽  
Different Doses

scholarly journals Efficacy and safety of anticoagulant therapy in patients with chronic cirrhosis complicated with portal vein thrombosis: what should we expert from a meta-analysis?

2020 ◽  
Author(s):  
Yalin Liu ◽  
Wanwei Chen ◽  
Liangbi Xu ◽  
Haoyi Yang ◽  
Chenhong Duan ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Anticoagulant Therapy ◽  
Meta Analysis ◽  
Anticoagulation Therapy ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Bleeding Events ◽  
Vein Thrombosis ◽  
The Difference

Abstract Background: Systematic review and meta-analysis were performed to evaluate efficacy and safety of anticoagulant therapy in patients with chronic cirrhosis complicated with portal vein thrombosis (PVT). Methods: The PubMed, The Cochrane Library and Web of Science databases were searched. The odds ratio (OR) and risks ratio(RR) with 95% CI was pooled to calculate the difference in the rate of portal vein recanalization and occurrence of bleeding events between patients who received anticoagulation and those who did not. All meta-analysis were conducted by using a random-effects model. Results: 8 studies with a total of 559 patients published between 2005 and 2019 were finally enrolled in our meta-analysis . The rate of portal vein recanalization was significantly higher with PVT who received anticoagulation and those who did not (OR = 4.689, 95% (95% CI = 3.274–6.716, P=0.000). And the pooled risk ratio of bleeding between the two groups was 0.828 (95% CI = 0.511–1.343, P=0.444). The heterogeneity was not statistically significant among studies, Begg’s funnel plot and Egger’s linear regression test were performed to evaluate publicantion bias. Conclusion: Anticoagulation therapy can significantly improve the recanalization rate of PVT patients with cirrhosis, and the bleeding related events caused by anticoagulation are relatively low, which is worthy of clinical promotion. However, more prospective trials are needed to know how to use anticoagulants.

scholarly journals Portal vein thrombosis in cirrhotic patients - it is always the small pieces that make the big picture

2018 ◽  
Vol 24 (39) ◽  
pp. 4419-4427 ◽  
Author(s):  
Irina Gîrleanu ◽  
Anca Trifan ◽  
Carol Stanciu ◽  
Cătălin Sfarti
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Vein Thrombosis ◽  
Big Picture ◽  
Cirrhotic Patients

scholarly journals Cerebellar hemorrhage in patients treated with edoxaban for portal vein thrombosis after hepatobiliary surgery: a report of two cases

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroya Iida ◽  
Toru Miyake ◽  
Masaji Tani ◽  
Takuya Tanaka ◽  
Kayo Kawakami ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Anticoagulation Therapy ◽  
Anterior Segment ◽  
Left Lobe ◽  
Ventricular Drainage ◽  
Hepatobiliary Surgery ◽  
Cerebellar Hemorrhage ◽  
Hematoma Evacuation ◽  
Vein Thrombosis

Abstract Background The standard therapeutic agent administered for portal vein thrombosis (PVT) in patients with or without cirrhosis is warfarin or low-molecular weight heparin. However, therapy with edoxaban appears to be one of the most promising treatments for patients who require anticoagulation therapy. We encountered two cases of cerebellar hemorrhage in patients treated with edoxaban for PVT after hepatobiliary surgery during the past 2 years. Case presentation Case 1 A 67-year-old male underwent cholecystectomy and choledocholithotomy with choledochoduodenostomy to treat choledocholithiasis after cholangitis. Enhanced computed tomography (CT) on the 1st postoperative day (POD) revealed thrombosis in the left and anterior segment of the portal vein branches. We administered antithrombin III concentrate with heparin for 5 days; thereafter, we switched to 60 mg edoxaban. A sudden decrease in the patient’s level of consciousness was observed due to cerebellar hemorrhage on POD 27. Cerebellar hemorrhage was successfully treated with craniotomy hematoma evacuation and ventricular drainage; however, the patient died from aggravation of hepatic failure due to PVT and intra-abdominal infection. Case 2 A 67-year-old male received laparoscopic microwave coagulation therapy for two hepatic nodules suggestive of hepatocellular carcinoma in the left lobe of the liver due to alcoholic hepatitis. Enhanced CT on POD 5 revealed a thrombosis in the 4th segment branch of the portal vein, and the patient was treated with 60 mg edoxaban. Cerebellar hemorrhage with ventricular perforation occurred on POD 15. Cerebellar hemorrhage was successfully treated by craniotomy hematoma evacuation with ventricular drainage. Prolonged consciousness disorder persisted, and the patient was transferred to another medical facility for rehabilitation 49 days after brain surgery. Conclusions Although edoxaban is recently described to be one of the options for patients with PVT who require anticoagulation therapy instead of heparin or warfarin, it should be used with caution, given its propensity to induce severe hemorrhagic adverse events in cases such as those described above. The monitoring of hepatic dysfunction and decision for continuation of drug may be required during edoxaban use for PVT, especially after hepatobiliary surgery.

Portal vein thrombosis in hepatitis C virus-related cirrhotic patients: Prevalence and clinical characteristics in an Egyptian cohort

2021 ◽  
pp. 004947552199850
Author(s):  
Omkolsoum Alhaddad ◽  
Maha Elsabaawy ◽  
Omar Elshaaraawy ◽  
Mohamed Elhalawany ◽  
Mohamed Mohamed Houseni ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Clinical Characteristics ◽  
Abdominal Ultrasound ◽  
Focal Lesion ◽  
Vein Thrombosis ◽  
Doppler Study ◽  
Cirrhotic Patients

Portal vein thrombosis is a catastrophe not uncommonly complicating hepatitis C virus-related liver cirrhosis. To estimate its prevalence and clinical characteristics, we investigated 1000 cirrhotic patients by abdominal ultrasound or Doppler study at least. Portal vein thrombosis was found in 21.6%, of whom 157 (72.7%) had malignancy. Complete portal vein thrombosis was found in 70.4%. Half of all these patients had at least one episode of portal hypertensive bleeding, a third had abdominal pain and a quarter presented with jaundice. Portal bilopathy was diagnosed in two cases (0.9%). There was significant association between severity of liver disease, ascites, male gender and site of segmental focal lesion and portal vein thrombosis.

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