Portal Vein Thrombosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (10 December 2021) | Viewed by 8402

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Medicina Interna 1, Azienda di Rilievo Nazionale ad Alta Specializzazione Civico - Di Cristina - Benfratelli, Piazzale Leotta 4, 90100 Palermo, Italy
Interests: liver; hepatology; portal vein; hepatitis
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ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Interests: hepatology; liver transplantation; hepatitis; cirrhosis

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General Hospital of Northern Theater Command,·Shenyang General Hospital of PLA, Shenyang, China
Interests: liver cirrhosis; portal hypertension; portal vein thrombosis; Budd–Chiari syndrome; hepatocellular carcinoma
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DHU UNITY, Serviced “hépatologie, Hôpital Beaujon, APHP; and CRI, UMR 1149, Université Paris Diderot, and Inserm, Paris, France
Interests: vascular liver diseases

Special Issue Information

Dear Colleagues,

Portal vein thrombosis (PVT) can affect patients with or without liver cirrhosis. However, the two clinical settings, respectively PVT with or without cirrhosis, are very different in both background and management considerations. In fact, while in the absence of cirrhosis PVT frequently relies on underlying pro-thrombotic factors (and consequently the need of anticoagulation is obvious), in the context of cirrhosis PVT is considered to be secondary to liver disease, and it is controversial whether PVT is a cause or a consequence of impaired liver function. Consequently, the opportunity of treating PVT in cirrhosis is an open issue. Furthermore, the option of interventional treatment for both settings is a valid one. However, which cases to treat with medical or interventional treatment is still controversial.

This Special Issue of the Journal of Clinical Medicine has the aim of investigating open issues about the etiology, pathophysiology, diagnosis, and management of PVT, both in cirrhosis and not.

Prof. Dr. Andrea Mancuso
Dr. Giovanni Perricone
Dr. Xingshun Qi
Prof. Dr. Dominique Valla
Guest Editors

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Keywords

  • portal vein thrombosis
  • cirrhosis
  • liver transplant

Published Papers (4 papers)

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Editorial

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5 pages, 200 KiB  
Editorial
Controversies in the Management of Portal Vein Thrombosis in Liver Cirrhosis
by Andrea Mancuso
J. Clin. Med. 2020, 9(12), 3916; https://doi.org/10.3390/jcm9123916 - 02 Dec 2020
Cited by 4 | Viewed by 1325
Abstract
Portal vein thrombosis (PVT) is frequently diagnosed in advanced-stage liver cirrhosis, with a reported prevalence of 10 to 25% [...] Full article
(This article belongs to the Special Issue Portal Vein Thrombosis)

Research

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8 pages, 487 KiB  
Article
Portal Vein Thrombosis Is Associated with an Increased Incidence of Depression and Anxiety Disorders
by Simon Johannes Gairing, Peter Robert Galle, Jörn M. Schattenberg, Karel Kostev and Christian Labenz
J. Clin. Med. 2021, 10(23), 5689; https://doi.org/10.3390/jcm10235689 - 02 Dec 2021
Cited by 1 | Viewed by 1702
Abstract
Portal vein thrombosis (PVT) is a severe disease that adversely affects patients’ well-being. Data on the influence of PVT on the occurrence of depression or anxiety disorders are lacking. This study aimed to explore the impact of PVT on the incidence of depression [...] Read more.
Portal vein thrombosis (PVT) is a severe disease that adversely affects patients’ well-being. Data on the influence of PVT on the occurrence of depression or anxiety disorders are lacking. This study aimed to explore the impact of PVT on the incidence of depression and anxiety disorders diagnoses in a large German primary care cohort over a ten-year period. Patients with PVT were matched to non-PVT individuals by age, sex, yearly consultation frequency, index year and comorbidities in a 1:5 ratio. The primary outcome of the study was the incidence of depression and anxiety disorders. The relationship between PVT and both depression and anxiety disorders was investigated using Cox regression models. We compared 547 patients with PVT with 2735 matched individuals without PVT. Within 5 years of the index date, 17.4% of patients with PVT and 9.3% of non-PVT individuals were diagnosed with depression (p < 0.001). Anxiety disorders were diagnosed in 5.5% and 3.0% of patients with PVT and non-PVT individuals, respectively (p = 0.002). On regression analyses, PVT was positively associated with incident depression (HR 2.01, 95% CI 1.53–2.64, p < 0.001) as well as anxiety disorders (HR 2.16, 95% CI 1.35–3.46, p = 0.001). Regarding depression, this association remained significant in women as well as in men. There was no association between PVT and the incidence of anxiety disorders in women. In conclusion, PVT is associated with the development of depression and anxiety disorders. However, further prospective studies are needed to confirm our findings before definitive recommendations can be made. Full article
(This article belongs to the Special Issue Portal Vein Thrombosis)
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17 pages, 2222 KiB  
Article
Portomesenteric Vein Thrombosis after Bariatric Surgery: An Online Survey
by Francesco Maria Carrano, Sylvia Weiner, Moustafa Elshafei, Saleem Ahmed, Toghrul Talishinskiy, Valeria Tognoni, Kamal Mahawar and Nicola Di Lorenzo
J. Clin. Med. 2021, 10(17), 4024; https://doi.org/10.3390/jcm10174024 - 06 Sep 2021
Cited by 7 | Viewed by 2158
Abstract
Portomesenteric vein thrombosis (PMVT) is a rare post-operative complication of bariatric procedures, occurring in between 0.3% and 1% of cases. A structured questionnaire consisting of 27 items was available online to members of the International Federation for the Surgery of Obesity and Metabolic [...] Read more.
Portomesenteric vein thrombosis (PMVT) is a rare post-operative complication of bariatric procedures, occurring in between 0.3% and 1% of cases. A structured questionnaire consisting of 27 items was available online to members of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) to investigate the occurrence of PMVT. A total of 89 bariatric surgeons from 61 countries participated. Twenty-six (29.21%) reported at least one case of PMVT (46.15% males; 53.84% females). The surgery most associated with PMVT occurrence was sleeve gastrectomy (84.6%), followed by Roux-en-Y gastric bypass (RYGB) (7.69%), and laparoscopic adjustable gastric banding (LAGB) (7.69%). The time gap between surgery and PMVT was 19.28 ± 8.72 days. The predominant symptom was abdominal pain in 96.15% of patients, followed by fever in 26.9%. Complete occlusion of the portal vein was reported in 34.6% of cases, with involvement of the portal system in 69%, extension to the superior mesenteric district in 23%, and extension to the splenic vein in two patients (7.7%). Our survey, which is the largest regarding PMVT to date, revealed a diffuse lack of standardization in the choice, duration, and dosing of prophylaxis regimens as well as treatment modalities, reflecting the literature gap on the topic. Full article
(This article belongs to the Special Issue Portal Vein Thrombosis)
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9 pages, 691 KiB  
Article
Vascular Complications in Patients with Chronic Pancreatitis
by Miroslav Vujasinovic, Ana Dugic, Amar Nouri, Torkel B Brismar, Francisco Baldaque-Silva, Ebba Asplund, Wiktor Rutkowski, Poya Ghorbani, Ernesto Sparrelid, Hannes Hagström and J.-Matthias Löhr
J. Clin. Med. 2021, 10(16), 3720; https://doi.org/10.3390/jcm10163720 - 21 Aug 2021
Cited by 5 | Viewed by 2198
Abstract
Introduction: Chronic pancreatitis (CP) is a long-standing progressive inflammation of the pancreas, which can lead to a variety of vascular complications, such as splanchnic venous thrombosis (VT) and arterial pseudoaneurysm (PA). There is a lack of studies on vascular complications in Scandinavian countries. [...] Read more.
Introduction: Chronic pancreatitis (CP) is a long-standing progressive inflammation of the pancreas, which can lead to a variety of vascular complications, such as splanchnic venous thrombosis (VT) and arterial pseudoaneurysm (PA). There is a lack of studies on vascular complications in Scandinavian countries. Methods: We performed a retrospective analysis of medical records of patients with CP identified from the Karolinska University Hospital database between 2003 and 2018. A total of 394 patients with definite CP were included in the study. Results: There were 33 patients with vascular complications, with a median age of 62 (IQR 55–72) years. The cumulative incidence of vascular events was 3.2% at 5 years. Thirty patients had isolated VT, whereas three patients had PA (7.6% and 0.8%, respectively). Isolated splenic vein thrombosis was most common (53.3%), followed by a combination with other splanchnic veins. PA was found in the splenic artery in two patients and in the left gastric artery in one patient. Varices were present in three (10%) patients; variceal bleeding was not recorded. All patients had asymptomatic splanchnic VT, most with chronic VT with developed collaterals (83.3% had abdominal collateral vessels). Nearly two-thirds of patients with VT (63.3%) received no treatment, whereas 11 (36.6%) were treated with anticoagulants. Pseudocysts and alcoholic etiology of CP are risk factors for vascular complications. Conclusions: The cumulative incidence of vascular complications was 3.2% at 5 years. Splanchnic VT is more common than PA. Patients were asymptomatic with no variceal bleeding, explained by well-developed collateral vessels and strong study inclusion criteria. Full article
(This article belongs to the Special Issue Portal Vein Thrombosis)
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