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Internal and Emergency Medicine

, Volume 11, Issue 8, pp 1059–1066 | Cite as

Portal vein thrombosis relevance on liver cirrhosis: Italian Venous Thrombotic Events Registry

  • Francesco VioliEmail author
  • Roberto Gino Corazza
  • Stephen Hugh Caldwell
  • Francesco Perticone
  • Angelo Gatta
  • Mario Angelico
  • Alessio Farcomeni
  • Michela Masotti
  • Laura Napoleone
  • Annarita Vestri
  • Valeria Raparelli
  • Stefania Basili
  • PRO-LIVER Collaborators
IM - ORIGINAL

Abstract

Portal vein thrombosis may occur in cirrhosis; nevertheless, its prevalence, and predictors are still elusive. To investigate this issue, the Italian Society of Internal Medicine undertook the “Portal vein thrombosis Relevance On Liver cirrhosis: Italian Venous thrombotic Events Registry” (PRO-LIVER). This prospective multicenter study includes consecutive cirrhotic patients undergoing Doppler ultrasound examination of the portal area to evaluate the prevalence and incidence of portal vein thrombosis over a 2-year scheduled follow-up. Seven hundred and fifty-three (68 % men; 64 ± 12 years) patients were included in the present analysis. Fifty percent of the cases were cirrhotic outpatients. Viral (44 %) etiology was predominant. Around half of the patients had a mild-severity disease according to the Child–Pugh score; hepatocellular carcinoma was present in 20 %. The prevalence of ultrasound-detected portal vein thrombosis was 17 % (n = 126); it was asymptomatic in 43 % of the cases. Notably, more than half of the portal vein thrombosis patients (n = 81) were not treated with anticoagulant therapy. Logistic step-forward multivariate analysis demonstrated that previous portal vein thrombosis (p < 0.001), Child–Pugh Class B + C (p < 0.001), hepatocellular carcinoma (p = 0.01), previous upper gastrointestinal bleeding (p = 0.030) and older age (p = 0.012) were independently associated with portal vein thrombosis. Portal vein thrombosis is a frequent complication of cirrhosis, particularly in patients with moderate–severe liver failure. The apparent undertreatment of patients with portal vein thrombosis is a matter of concern and debate, which should be addressed by planning interventional trials especially with newer oral anticoagulants.

Clinicaltrials.gov identifier NCT01470547.

Keywords

Splanchnic venous thrombosis Anticoagulants Liver failure Hepatocellular carcinoma Esophageal varices 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Financial support

Nothing to declare.

Supplementary material

11739_2016_1416_MOESM1_ESM.doc (16 kb)
Supplementary material 1 (DOCX 16 kb)
11739_2016_1416_MOESM2_ESM.docx (13 kb)
Supplementary material 2 (DOCX 13 kb)

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Copyright information

© SIMI 2016

Authors and Affiliations

  • Francesco Violi
    • 1
    Email author
  • Roberto Gino Corazza
    • 2
  • Stephen Hugh Caldwell
    • 3
  • Francesco Perticone
    • 4
  • Angelo Gatta
    • 5
  • Mario Angelico
    • 6
  • Alessio Farcomeni
    • 7
  • Michela Masotti
    • 2
  • Laura Napoleone
    • 1
  • Annarita Vestri
    • 7
  • Valeria Raparelli
    • 1
  • Stefania Basili
    • 1
  • PRO-LIVER Collaborators
  1. 1.I Clinica Medica, Department of Internal Medicine and Medical SpecialtiesSapienza-University of RomeRomeItaly
  2. 2.First Department of Internal Medicine, Fondazione IRCCS Policlinico San MatteoUniversity of PaviaPaviaItaly
  3. 3.Division of Gastroenterology and Hepatology, Digestive Health CenterUniversity of VirginiaCharlottesvilleUSA
  4. 4.Department of Medical and Surgical SciencesUniversity of CatanzaroCatanzaroItaly
  5. 5.Department of MedicineUniversity of PadovaPaduaItaly
  6. 6.Liver UnitUniversity Hospital Tor VergataRomeItaly
  7. 7.Department of Public Health and Infectious DiseaseSapienza-University of RomeRomeItaly

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