Portal vein thrombosis: When to treat and how?

Vasc Med. 2016 Feb;21(1):61-9. doi: 10.1177/1358863X15611224. Epub 2015 Nov 19.

Abstract

Portal vein thrombosis is an unusual thrombotic condition not frequently seen in the general population; however, it has a higher prevalence in special circumstances such as in liver cirrhosis and hepatic or pancreatic malignancy. It also can be associated with significant morbidity and mortality. In this review, we discuss the current data available to guide therapy in the setting of different associated co-morbidities, hypercoagulable states, and associated thrombosis of the remaining splanchnic circulation. We discuss indications for anticoagulation, including the choice of anticoagulants, as well as the role of conservative 'wait and watch' and invasive therapies, such as thrombolysis, thrombectomy, and transjugular intrahepatic portosystemic shunt.

Keywords: DOAC; PVT; blood coagulation disorders; thromboembolism; thrombosis.

Publication types

  • Review

MeSH terms

  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Blood Coagulation / drug effects*
  • Humans
  • Phlebography / methods
  • Portal Vein / diagnostic imaging
  • Portal Vein / surgery*
  • Portasystemic Shunt, Transjugular Intrahepatic* / adverse effects
  • Risk Factors
  • Thrombectomy* / adverse effects
  • Thrombolytic Therapy* / adverse effects
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Venous Thrombosis / blood
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / epidemiology
  • Venous Thrombosis / therapy*

Substances

  • Anticoagulants