scholarly journals No Association of Homocysteine, Anticardiolipin Antibody, and Anti-β2 Glycoprotein I Antibody With Portal Venous System Thrombosis in Liver Cirrhosis

2021 ◽  
Vol 27 ◽  
pp. 107602962110109
Author(s):  
Le Wang ◽  
Xiaozhong Guo ◽  
Xiangbo Xu ◽  
Shixue Xu ◽  
Juqiang Han ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Anticardiolipin Antibody ◽  
Venous System ◽  
Common Complication ◽  
Portal Venous System ◽  
Main Portal Vein ◽  
Glycoprotein I ◽  
Cirrhotic Patients ◽  
Clinically Significant

Portal venous system thrombosis (PVST), a common complication of liver cirrhosis, is closely associated with thrombophilia. To explore the association of homocysteine (Hcy), anticardiolipin antibody (aCL), and anti-β2 glycoprotein I antibody (aβ2GPI), which are possible thrombophilic factors, with PVST in liver cirrhosis. Overall, 654 non-malignant patients (219 with and 435 without liver cirrhosis) admitted between January 2016 and June 2020 were retrospectively evaluated. Presence of PVST, degree of main portal vein (MPV) thrombosis, and clinically significant PVST were identified. Hcy level, hyperhomocysteinemia (HHcy), aCL positivity, and aβ2GPI positivity were compared according to the presence of liver cirrhosis and PVST. Positive aβ2GPI was significantly more frequent in patients with liver cirrhosis than those without, but Hcy level and proportions of HHcy and positive aCL were not significantly different between them. PVST could be evaluated in 136 cirrhotic patients. Hcy level [10.57 μmol/L (2.71-56.82) versus 9.97 μmol/L (2.05-53.44); P = 0.796] and proportions of HHcy [4/44 (9.1%) versus 13/81 (16.0%); P = 0.413] and positive aCL [1/23 (4.3%) versus 10/52 (19.2%); P = 0.185] and aβ2GPI [9/23 (39.1%) versus 21/52 (40.4%); P = 0.919] were not significantly different between cirrhotic patients with and without PVST. There was still no significant association of Hcy level, HHcy, aCL, or aβ2GPI with PVST based on Child-Pugh classification, MPV thrombosis >50%, and clinically significant PVST. Hcy, aCL, and aβ2GPI may not be associated with PVST in liver cirrhosis, suggesting that routine screening for Hcy, aCL, and aβ2GPI should be unnecessary in such patients.

Aberrant Left Gastric Vein Directly Draining into Left Portal Venous System

1992 ◽  
Vol 33 (5) ◽  
pp. 462-463 ◽  
Author(s):  
H. Tajima ◽  
R. Murakami ◽  
T. Kumazaki
Keyword(s):  
Gastric Cancer ◽  
Liver Cirrhosis ◽  
Early Gastric Cancer ◽  
Portal Vein ◽  
Venous System ◽  
Portal Venous System ◽  
Left Gastric Vein ◽  
Direct Communication ◽  
Vein System ◽  
Left Portal Vein

A 66-year-old man with early gastric cancer and liver cirrhosis was diagnosed by preoperative angiography as having an aberrant left gastric vein communicating directly with the left lateral portal vein system. This communication was confirmed during operation for the gastric cancer. Our report is the first of an aberrant left gastric vein showing direct communication with the left portal vein system.

scholarly journals Portal Vein Thrombosis: Diagnosis and Endovascular Management

2021 ◽  
Author(s):  
Connie Ju ◽  
Xin Li ◽  
Sameer Gadani ◽  
Baljendra Kapoor ◽  
Sasan Partovi
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Underlying Disease ◽  
Venous System ◽  
Portal Venous System ◽  
Endovascular Management ◽  
Vein Thrombosis ◽  
Endovascular Interventions ◽  
Clinically Significant ◽  
Optimal Approach

Background Portal vein thrombosis (PVT) is a rare but severe entity that can cause clinically significant sequela such as worsening portal hypertension or mesenteric ischemia. Those cases refractory to medical management may be referred for endovascular intervention. Several technical considerations have been described in the literature, but a cohesive comparison of these multiple techniques is lacking. Methods The purpose of this article is to review the diagnosis and endovascular management of PVT, including areas in which further research is warranted. Results Cases of PVT can be readily diagnosed using ultrasound, computed tomography, or magnetic resonance imaging. Treatment often begins with systemic anticoagulation and endovascular interventions may be used in selected cases. Determining the optimal approach to accessing the portal venous system depends on the underlying disease and chronicity of the thrombus and the degree of occlusion. Once access to the portal venous system is established, catheter-directed therapy may be performed to achieve recanalization. Conclusion Despite the heterogeneity in patient presentation, cases of PVT can be readily diagnosed across several imaging modalities. Strategizing interventional approaches involves evaluation of the underlying disease and the chronicity of the thrombus. Key Points:  Citation Format

scholarly journals Association of thromboelastography profile with severity of liver cirrhosis and portal venous system thrombosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yanglan He ◽  
Shanshan Yuan ◽  
Xiaozhong Guo ◽  
Fangfang Yi ◽  
Xiangbo Xu ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Maximum Amplitude ◽  
Cross Sectional Study ◽  
Venous System ◽  
High Rate ◽  
Portal Venous System ◽  
Cross Sectional ◽  
Class A ◽  
Pugh Class ◽  
Cirrhotic Patients

Abstract Background and aim Hemostasis profile is often complicated in liver cirrhosis. Thromboelastography is a global viscoelastic test recommended by the current practice guideline and consensus. This cross-sectional study aimed to evaluate the association of thromboelastography profile with severity of liver cirrhosis and presence of portal venous system thrombosis (PVST). Methods Overall, 116 and 50 cirrhotic patients were included in the Shenyang and Xi’an cohorts, respectively. Thromboelastography parameters were compared between cirrhotic patients with Child–Pugh class A and B/C, those with and without decompensated events, and those with and without PVST. Hypercoagulability would be considered if at least two of the following thromboelastography parameters were met: shortened reactive time (R), shortened coagulation time (K), increased angle, and increased maximum amplitude (MA). Results In the Shenyang cohort, 16 patients had shortened R, of whom seven (43.75%) had prolonged K and 11 (68.75%) decreased MA. In the Xi’an cohort, 24 patients had shortened R, of whom seven (29.17%) had prolonged K and 15 (62.50%) decreased MA. In the Shenyang cohort, the prevalence of hypercoagulability was not significantly different between cirrhotic patients with Child–Pugh class A and B/C (3.85% vs. 6.25%, P = 0.873), those with and without decompensated events (5.49% vs. 4.00%, P = 1.000), and those with and without PVST (4.17% vs. 5.88%, P = 1.000), which were similar to the results obtained in the Xi’an cohort. Conclusion There is a high rate of discordance between R and other thromboelastography parameters. In addition, hypercoagulability may not be related to more advanced stage of liver cirrhosis or presence of PVST.

scholarly journals Doppler ultrasound in liver cirrhosis: correlation of hepatic artery and portal vein measurements with model for end-stage liver disease score in Egypt

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Ahmed Abdelrahman Mohamed Baz ◽  
Rana Magdy Mohamed ◽  
Khaled Helmy El-kaffas
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Meld Score ◽  
Hepatic Decompensation ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
Us Findings ◽  
End Stage

Abstract Background Liver cirrhosis is a multi-etiological entity that alters the hepatic functions and vascularity by varying grades. Hereby, a cross-sectional study enrolling 100 cirrhotic patients (51 males and 49 females), who were diagnosed clinically and assessed by model for end-stage liver disease (MELD) score, then correlated to the hepatic Doppler parameters and ultrasound (US) findings of hepatic decompensation like ascites and splenomegaly. Results By Doppler and US, splenomegaly was evident in 49% of patients, while ascites was present in 44% of them. Increased hepatic artery velocity (HAV) was found in70% of cases, while 59% showed reduced portal vein velocity (PVV). There was a statistically significant correlation between HAV and MELD score (ρ = 0.000), but no significant correlation with either hepatic artery resistivity index (HARI) (ρ = 0.675) or PVV (ρ =0.266). Moreover, HAV had been correlated to splenomegaly (ρ = 0.000), whereas HARI (ρ = 0.137) and PVV (ρ = 0.241) did not significantly correlate. Also, ascites had correlated significantly to MELD score and HAV (ρ = 0.000), but neither HARI (ρ = 0.607) nor PVV (ρ = 0.143) was significantly correlated. Our results showed that HAV > 145 cm/s could confidently predict a high MELD score with 62.50% and 97.62 % sensitivity and specificity. Conclusion Doppler parameters of hepatic vessels (specifically HAV) in addition to the US findings of hepatic decompensation proved to be a non-invasive and cost-effective imaging tool for severity assessment in cirrhotic patients (scored by MELD); they could be used as additional prognostic parameters for improving the available treatment options and outcomes.

scholarly journals The ABCD of portal vein thrombosis: a systematic approach

2020 ◽  
Vol 53 (6) ◽  
pp. 424-429
Author(s):  
Alexandre Makoto Minoda ◽  
Raissa Brito Fernandes Cadete ◽  
Sara Reis Teixeira ◽  
Valdair Francisco Muglia ◽  
Jorge Elias Junior ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Systematic Approach ◽  
Careful Analysis ◽  
Venous System ◽  
Portal Venous System ◽  
Vein Thrombosis ◽  
Case Files ◽  
Collateral Vessels ◽  
And Diffusion

Abstract Portal vein thrombosis refers to complete or partial obstruction of the portal venous system, in the intrahepatic or extrahepatic venous tract or even in the splenic or superior mesenteric veins. This common and potentially fatal condition can develop in various clinical contexts, especially those of liver cirrhosis, hepatocellular carcinoma, and other solid tumors. Certain characteristics, such as the time since the onset of the thrombus (acute or chronic), its biology (hematic or tumoral), the presence of collateral vessels, and the magnetic resonance imaging aspects, are important components of a thorough, careful analysis, as well as informing decisions regarding the appropriate therapeutic strategy. Here, we present a brief review of the anatomy of the portal venous system and a systematic approach to analyzing the condition, using a mnemonic (ABCD, for age, biology, collaterals, and diffusion). We discuss the various imaging methods and illustrate our discussion with images selected from the case files archived at our facility.

scholarly journals Systemic and Splanchnic Lipopolysaccharide and Endothelin-1 Plasma Levels in Liver Cirrhosis before and after Transjugular Intrahepatic Portosystemic Shunt

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Jiaxiang Meng ◽  
Qing Wang ◽  
Kai Liu ◽  
Shuofei Yang ◽  
Xinxin Fan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Bacterial Translocation ◽  
Portosystemic Shunt ◽  
Before And After ◽  
Intrahepatic Portosystemic Shunt ◽  
Cirrhotic Patients

Lipopolysaccharide (LPS) and endothelin- (ET-) 1 may aggravate portal hypertension by increasing intrahepatic resistance and splanchnic blood flow. In the portal vein, after TIPS shunting, LPS and ET-1 were significantly decreased. Our study suggests that TIPS can benefit cirrhotic patients not only in high hemodynamics related variceal bleeding but also in intestinal bacterial translocation associated complications such as endotoxemia.

scholarly journals Spontaneous portosystemic shunts in liver cirrhosis: new approaches to an old problem

2020 ◽  
Vol 13 ◽  
pp. 175628482096128 ◽  
Author(s):  
Judit Vidal-González ◽  
Sergi Quiroga ◽  
Macarena Simón-Talero ◽  
Joan Genescà
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Portosystemic Shunt ◽  
Venous System ◽  
Variceal Hemorrhage ◽  
Portal Venous System ◽  
Portal Flow ◽  
Portosystemic Shunts ◽  
Intrahepatic Portosystemic Shunt

Portal hypertension is the main consequence of liver cirrhosis, leading to severe complications such as variceal hemorrhage, ascites or hepatic encephalopathy. As an attempt to decompress the portal venous system, portal flow is derived into the systemic venous system through spontaneous portosystemic shunts (SPSSs), bypassing the liver. In this review, we aim to provide an overview of the published reports in relation to the prevalence and physiopathology behind the appearance of SPSS in liver cirrhosis, as well as the complications derived from its formation and its management. The role of SPSS embolization is specifically discussed, as SPSSs have been assessed as a therapeutic target, mainly for patients with recurrent/persistent hepatic encephalopathy and preserved liver function. Furthermore, different aspects of the role of SPSS in liver transplantation, as well as in candidates for transjugular intrahepatic portosystemic shunt are reviewed. In these settings, SPSS occlusion has been proposed to minimize possible deleterious effects, but results are so far inconclusive.

scholarly journals Diagnosis and management of portal vein thrombosis in patients with cirrhosis of liver

2018 ◽  
Vol 6 (26) ◽  
pp. 10-16
Author(s):  
Logan Adams ◽  
Somedeb Ball
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Common Complication ◽  
Portal Venous System ◽  
Vein Thrombosis ◽  
Contrast Enhanced ◽  
Chronic Complication ◽  
Hypertension Portal ◽  
Intrahepatic Portosystemic Shunt ◽  
Cirrhosis Of Liver

Portal vein thrombosis (PVT) is an occlusion of the portal venous system and is a common complication of liver cirrhosis. It can present as either an acute or chronic complication. Acute PVT can present with abdominal pain, diarrhea, ileus, and bleeding. Chronic PVT is often asymptomatic; however, it can be discovered in cases of worsening portal hypertension. Portal vein thrombosis is diagnosed by imaging modalities, such as ultrasound and computed tomography. Contrast-enhanced imaging can be used in cases with difficult visualization. Despite the hemostatic imbalance in cirrhosis, anticoagulants can be safely used to recanalize the vein. Transjugular intrahepatic portosystemic shunt procedures are also an effective method for recanalization.

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