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Portal Vein Thrombosis

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1. Band ligation versus beta-blockers for primary prophylaxis of oesophageal variceal bleeding in children with chronic liver disease or portal vein thrombosis. (Abstract)

Band ligation versus beta-blockers for primary prophylaxis of oesophageal variceal bleeding in children with chronic liver disease or portal vein thrombosis. Portal hypertension commonly accompanies advanced liver disease and often gives rise to life-threatening complications, including haemorrhage from oesophageal and gastrointestinal varices. Variceal haemorrhage commonly occurs in children with chronic liver disease or portal vein obstruction. Prevention is therefore important. Following (...) vein thrombosis are lacking. There is a need for well-designed, adequately powered randomised clinical trials to assess the benefits and harms of band ligation versus beta-blockers for primary prophylaxis of oesophageal variceal bleeding in children with chronic liver disease or portal vein thrombosis. Those randomised clinical trials should include patient-relevant clinical outcomes such as mortality, failure to control bleeding, and adverse events.

2019 Cochrane

4. Development of a Model to Predict Portal Vein Thrombosis in Liver Transplant Candidates: The Portal Vein Thrombosis Risk Index. (Abstract)

Development of a Model to Predict Portal Vein Thrombosis in Liver Transplant Candidates: The Portal Vein Thrombosis Risk Index. Portal vein thrombosis (PVT) is associated with inferior pretransplantation and posttransplantation outcomes. We aimed to create a predictive model to risk stratify transplant candidates for PVT. Data on adult transplants in the United States during the Model for End-Stage Liver Disease (MELD) era through September 2016 were reviewed. We constructed and validated

2019 Liver Transplantation

5. Imaging of the intrahepatic portal vein in children with extrahepatic portal vein thrombosis - Comparison of magnetic resonance imaging and retrograde portography. (Abstract)

Imaging of the intrahepatic portal vein in children with extrahepatic portal vein thrombosis - Comparison of magnetic resonance imaging and retrograde portography. Extrahepatic portal vein thrombosis (EPVT) is one major cause of portal hypertension in children. Surgical reinstallation of portal venous flow can be achieved in patients with patent intrahepatic portal venous system/Rex recess. Our study aimed to compare the ability of magnetic resonance imaging (MRI) and retrograde portography (RP (...) portal venous system in children with EPVT, whereas MRI has shown to be unsuitable for the assessment of the intrahepatic portal vein in these patients. In the preoperative setup, we recommend both procedures, RP and MRI for the visualization of the intrahepatic portal venous system, and the extrahepatic vessels, respectively.Level III.Copyright © 2018 Elsevier Inc. All rights reserved.

2018 Journal of Pediatric Surgery

6. Long-term outcomes of transmesenteric portal vein recanalization for the treatment of chronic portal vein thrombosis after pediatric liver transplantation. Full Text available with Trip Pro

Long-term outcomes of transmesenteric portal vein recanalization for the treatment of chronic portal vein thrombosis after pediatric liver transplantation. Portal vein thrombosis (PVT) may occur at any time following liver transplantation. We describe our experience with portal vein recanalization in cases of thrombosis after liver transplantation. Twenty-eight children (5%) out of 566 liver transplant recipients underwent portal vein recanalization using a transmesenteric approach. All (...) children received left hepatic segments, developed PVT, and had symptoms or signs of portal hypertension. Portal vein recanalization was performed via the transmesenteric route in all cases. Twenty-two (78.6%) patients underwent successful recanalization and stent placement. They received oral anticoagulants after the procedure, and clinical symptoms subsided. Symptoms recurred due to portal vein restenosis/thrombosis in seven patients. On an intention-to-treat basis, the success rate of the proposed

2018 American Journal of Transplantation

7. Timing of Anticoagulation for Portal Vein Thrombosis in Liver Cirrhosis: A US Hepatologist’s Perspective Full Text available with Trip Pro

Timing of Anticoagulation for Portal Vein Thrombosis in Liver Cirrhosis: A US Hepatologist’s Perspective 29607296 2019 01 28 2450-131X 6 1 2018 Mar Journal of translational internal medicine J Transl Int Med Timing of Anticoagulation for Portal Vein Thrombosis in Liver Cirrhosis: A US Hepatologist's Perspective. 1-5 10.2478/jtim-2018-0001 Northup Patrick G PG MD Center for the Study of Coagulation in Liver Disease, Division of Gastroenterology and Hepatology, University of Virginia

2018 Journal of translational internal medicine

8. Timing of Anticoagulation for Portal Vein Thrombosis in Liver Cirrhosis: An Italian Internist’s Perspective Full Text available with Trip Pro

Timing of Anticoagulation for Portal Vein Thrombosis in Liver Cirrhosis: An Italian Internist’s Perspective 29607297 2019 01 28 2450-131X 6 1 2018 Mar Journal of translational internal medicine J Transl Int Med Timing of Anticoagulation for Portal Vein Thrombosis in Liver Cirrhosis: An Italian Internist's Perspective. 6-10 10.2478/jtim-2018-0002 Riva Nicoletta N Department of Pathology, University of Malta, Msida, Malta. Ageno Walter W Department of Medicine and Surgery, University (...) of Insubria, Varese, Italy. eng Journal Article 2018 03 28 Poland J Transl Int Med 101673826 2224-4018 Conflict of Interest: Walter Ageno has received a research grant from Bayer to support a clinical study in patients with splanchnic vein thrombosis. Nicoletta Riva has no relevant conflicts to declare in relation to this paper. 2018 4 3 6 0 2018 4 3 6 0 2018 4 3 6 1 epublish 29607297 10.2478/jtim-2018-0002 jtim-2018-0002 PMC5874480 World J Hepatol. 2015 Jul 18;7(14):1818-27 26207163 J Clin Gastroenterol

2018 Journal of translational internal medicine

9. Timing of the Treatment of Portal Vein Thrombosis in Patients with Cirrhosis: A German Hepatologist’s Perspective Full Text available with Trip Pro

Timing of the Treatment of Portal Vein Thrombosis in Patients with Cirrhosis: A German Hepatologist’s Perspective 29607298 2019 01 28 2450-131X 6 1 2018 Mar Journal of translational internal medicine J Transl Int Med Timing of the Treatment of Portal Vein Thrombosis in Patients with Cirrhosis: A German Hepatologist's Perspective. 11-15 10.2478/jtim-2018-0003 Rössle Martin M MD University Hospital, Department of Gastroenterology and Hepatology, Hugstetterstrasse 55, 79106, Freiburg, Germany

2018 Journal of translational internal medicine

10. Yttrium-90 trans-arterial radioembolization in advanced-stage HCC: The impact of portal vein thrombosis on survival. Full Text available with Trip Pro

Yttrium-90 trans-arterial radioembolization in advanced-stage HCC: The impact of portal vein thrombosis on survival. Portal vein thrombosis (PVT) is generally recognized as a prognostic factor in HCC. Our purpose is to assess and compare the survival of patients with PVT and without PVT, after Y-90 Trans-Arterial Radio-Embolization (TARE) of unresectable HCC, unresponsive to other loco-regional treatments.Between November 2005 and November 2012, Y-90 resin-based TARE was performed in an IRB (...) . No significant difference was found in survival of patients with PVT compared to those without PVT (p-value = 0.672). A complete regression of PVT was observed in almost half patients (13/27, 48.1%).Portal vein invasion does not affect survival in advanced stage HCC-patients undergoing TARE using Y-90 resin-based microspheres. Y90 procedure is associated with regression of portal vein tumor thrombus.

2019 PLoS ONE

11. Effects of Portal Vein Thrombosis on the Outcomes of Liver Cirrhosis: A Mexican Perspective Full Text available with Trip Pro

Effects of Portal Vein Thrombosis on the Outcomes of Liver Cirrhosis: A Mexican Perspective 29340273 2019 01 28 2450-131X 5 4 2017 Dec Journal of translational internal medicine J Transl Int Med Effects of Portal Vein Thrombosis on the Outcomes of Liver Cirrhosis: A Mexican Perspective. 189-191 10.1515/jtim-2017-0031 Cruz-Ramón Vania V Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico. Chinchilla-López Paulina P Liver Research Unit, Medica Sur Clinic & Foundation, Mexico

2017 Journal of translational internal medicine

12. Extra-Anatomic Jump Graft from the Right Colic Vein: A Novel Technique to Manage Portal Vein Thrombosis in Liver Transplantation Full Text available with Trip Pro

Extra-Anatomic Jump Graft from the Right Colic Vein: A Novel Technique to Manage Portal Vein Thrombosis in Liver Transplantation In the context of cirrhosis, portal vein thrombosis (PVT) is present in 2.1% to 26% of patients. PVT is no longer considered an absolute contraindication for liver transplantation, and nowadays, surgical strategies depend on the extent of PVT. Complete PVT is associated with higher morbidity rates and poor prognosis, while comparable long-term outcomes can be achieved (...) as long as physiological portal inflow is restored.We report our experience with a 45-year-old patient undergoing liver transplant with a PVT (stage III-b). To restore portal vein inflow to the liver, an extra-anatomic jump graft from the right colic vein with donor iliac vein interposition was constructed.The patient recovered well, with a progressive improvement of the general conditions, and was finally discharged on p.o.d. 14. No anastomotic defects were found at the postoperative CT scan 10

2018 Case reports in surgery

13. Decreased Portal Vein Velocity is Predictive of the Development of Portal Vein Thrombosis: a Matched Case-Control Study. (Abstract)

Decreased Portal Vein Velocity is Predictive of the Development of Portal Vein Thrombosis: a Matched Case-Control Study. Portal vein thrombosis (PVT) in cirrhosis may lead to hepatic decompensation and increased mortality. We aimed to investigate if decreased portal vein (PV) velocity is associated with future PVT.Data on adult patients with cirrhosis and PVT between January 1, 2005 and July 30, 2015 were obtained. Cases with PVT were matched by age, gender and Model for End-stage Liver Disease

2017 Liver International

14. Significance of Measured Intraoperative Portal Vein Flows After Thrombendvenectomy in Deceased Donor Liver Transplants with Portal Vein Thrombosis. Full Text available with Trip Pro

Significance of Measured Intraoperative Portal Vein Flows After Thrombendvenectomy in Deceased Donor Liver Transplants with Portal Vein Thrombosis. Adequate portal vein (PV) flow in liver transplantation is essential for a good outcome, and it may be compromised in patients with portal vein thrombosis (PVT). This study evaluated the impact of intraoperatively measured PV flow after PV thrombendvenectomy on outcomes after deceased donor liver transplantation (DDLT). The study included 77 (...) %, and 68% versus 64%, 55%, and 38%, respectively; P = 0.002). There was no difference in the incidence of postoperative PVT between the groups (1.8% versus 9.1%; P = 0.19). No biliary leaks or hepatic artery thromboses were reported in either group. By multivariate analyses, age >60 years (hazard ratio [HR], 3.04, 95% confidence interval [CI], 1.36-6.82; P = 0.007) and low portal flow (HR, 2.31; 95% CI, 1.15-4.65; P = 0.02) were associated with worse survival. In conclusion, PV flow <1300 mL/minute

2017 Liver Transplantation

15. The prognosis of bulky hepatocellular carcinoma with nonmajor branch portal vein tumor thrombosis. Full Text available with Trip Pro

The prognosis of bulky hepatocellular carcinoma with nonmajor branch portal vein tumor thrombosis. A bulky, solitary hepatocellular carcinoma (HCC) with nonmajor branch portal vein tumor thrombosis (PVTT) was staged as T2 in the tumor-node-metastasis (TNM) system. We aimed to evaluate the prognosis of this group of patients.A total of 2643 patients with HCC in a medical center were consecutively enrolled. The stage of HCC was determined according to the 7th edition of American Joint Committee (...) on Cancer staging system. Patients who were diagnosed as having solitary HCC larger than 5 cm with nonmajor portal vein thrombosis (VP1-VP2) and no lymphadenopathy or metastasis were included.Bulky HCC with nonmajor branch PVTT and without metastasis and lymphadenopathy was identified in 0.15% (4 out of 2643 patients) of the patients with HCC. Child-Pugh scores of the patients were A to B. Tumor sizes all were larger than 5 cm (mean: 6.8 ± 1.0 cm). All patients had nonmajor branch of PVTT. Three

2019 Medicine

16. Incidence, predictive factors and clinical significance of development of portal vein thrombosis in cirrhosis: a prospective study. (Abstract)

Incidence, predictive factors and clinical significance of development of portal vein thrombosis in cirrhosis: a prospective study. The role of portal vein thrombosis (PVT) in the natural history of cirrhosis is controversial. There are few prospective studies validating risk factors for development of PVT. We analyzed the incidence, factors associated with PVT development and its influence on cirrhosis decompensations and orthotopic liver transplant (OLT) free survival.In this prospective (...) decompensations (HR 1.14; 95%C.I.:1.09-1.19) and OLT free survival (HR 1.16;95%C.I.:1.11-1.21).Previous decompensations of cirrhosis and thrombocytopenia predict PVT development in cirrhosis suggesting a pathophysiologic role for severity of portal hypertension. PVT development did not independently predict cirrhosis decompensations or lower OLT free survival. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.

2019 Liver International

17. Concomitant Infection With Epstein-Barr Virus and Cytomegalovirus Infection Leading to Portal Vein Thrombosis. (Abstract)

Concomitant Infection With Epstein-Barr Virus and Cytomegalovirus Infection Leading to Portal Vein Thrombosis. Portal vein thrombosis (PVT) is well recognized as a complication of hepatic cirrhosis and is likely to be suspected in patients with hypercoagulable syndromes, however, it is rarely recognized as a possibility in otherwise healthy patients with Epstein-Barr virus (EBV) or cytomegalovirus (CMV) infection. We report a case of a healthy 27-year-old man with fever and weight loss who (...) , or jaundice. Laboratory tests revealed titers diagnostic of acute EBV and CMV infection with elevated liver function tests and leukocytosis with lymphocyte predominance (white blood cell count 15,400/μL; 43% atypical lymphocytes). Computed tomography of the abdomen/pelvis with i.v. contrast showed a filling defect in the anterior portal vein. The patient was admitted with the ED diagnosis of PVT secondary to viral infection and was initiated on anticoagulation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE

2019 Journal of Emergency Medicine

18. Warfarin versus aspirin prevents portal vein thrombosis after laparoscopic splenectomy and azygoportal disconnection: A randomized clinical trial. (Abstract)

Warfarin versus aspirin prevents portal vein thrombosis after laparoscopic splenectomy and azygoportal disconnection: A randomized clinical trial. Portal vein system thrombosis (PVST) is a common, potentially life-threatening complication after splenectomy. The optimal recognized anticoagulation drugs for preventing PVST in cirrhotic patients after splenectomy remain unclear. The aim of this study is to evaluate the safety and efficacy of warfarin in preventing PVST after laparoscopic

2019 International journal of surgery (London, England) Controlled trial quality: predicted high

19. Novel classification of non-malignant portal vein thrombosis: A guide to surgical decision-making during liver transplantation. Full Text available with Trip Pro

Novel classification of non-malignant portal vein thrombosis: A guide to surgical decision-making during liver transplantation. Non-tumoral portal vein thrombosis (PVT) is present at liver transplantation in 5% to 26% of cirrhotic patients, and the prevalence of complex PVT as defined here (grade 4 Yerdel, and grade 3,4 Jamieson and Charco) has been reported in 0% to 2.2%. Adequate portal inflow is mandatory to ensure graft and patient survival after liver transplantation. With time (...) -physiological portal inflow reconstruction, and subsequently, iii) proposes a new classification of non-tumoral PVT in candidates for liver transplantation; to help tailor the surgical strategy to an individual patient, in order to provide portal inflow to the graft together with control of prehepatic portal hypertension whenever feasible.Copyright © 2019. Published by Elsevier B.V.

2019 Journal of Hepatology

20. Extensive Thrombectomy as a Legitimate Strategy in Living Donor Liver Transplantation With Advanced Portal Vein Thrombosis. (Abstract)

Extensive Thrombectomy as a Legitimate Strategy in Living Donor Liver Transplantation With Advanced Portal Vein Thrombosis. Management of portal vein thrombosis (PVT), especially advanced PVT involving the superior mesenteric vein (SMV), in living donor liver transplantation (LDLT) is challenging. There were 514 adults who underwent LDLT between 2005 and 2018 included in this retrospective study, and PVT was observed in 67 (13.0%) patients. The LDLT recipients with PVT were characterized (...) by increased portal pressure at laparotomy (26.1 ± 6.0 versus 24.3 ± 5.9 mm Hg; P = 0.03) and at closure (16.8 ± 3.9 versus 15.6 ± 3.6 mm Hg; P = 0.02), increased operative blood loss (14.6 ± 29.7 versus 5.7 ± 6.3 L; P < 0.01), and decreased 1-year graft survival (83.5% versus 92.8%; P = 0.04). Among the 18 patients with atrophic or vanished portal vein on pre-LDLT computed tomography, significant portal atrophy was actually observed only in 1 (5.6%) patient during LDLT surgery. For advanced PVT (n = 7

2019 Liver Transplantation

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