Long-term efficacy and safety of anticoagulant for cavernous transformation of the portal vein cirrhotic patient with extrahepatic portal vein obstruction

Thrombosis Journal

Research

Zhiquan Zhuang¹  Tianzhu Yu²  Jiaze Yu³  Yongjie Zhou³  Jingqin Ma³  Wen Zhang³  Jianjun Luo⁴  Zhiping Yan⁴ 

[1] Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China;Department of Interventional Radiology, Xiamen Branch, Zhongshan Hospital, Fudan University, Shanghai, China;Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China;Shanghai Institution of Medical Imaging, Shanghai, China;Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China;Shanghai Institution of Medical Imaging, Shanghai, China;National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China;Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China;Shanghai Institution of Medical Imaging, Shanghai, China;National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China;Center for Tumor Diagnosis and Therapy, Jinshan Hospital, Fudan University, Shanghai, China;

关键词: Portal vein thrombosis;    Cavernous transformation of the portal vein;    Extrahepatic portal vein obstruction;    Cirrhosis;    Warfarin;    Hepatic decompensation;   

DOI  :  10.1186/s12959-023-00449-8

 received in 2022-09-15, accepted in 2023-01-05,  发布年份 2023

来源: Springer

【 摘 要 】

Background/aimsCavernous transformation of the portal vein (CTPV) in cirrhotic patients with extrahepatic portal vein obstruction (EHPVO) was a relatively rare disease and had no consensus on the treatment. Our study aimed to explore the value of anticoagulation with warfarin treatment for CTPV cirrhotic patients with EHPVO.Methods: From January 2015 to December 2019, the clinical characteristics of cirrhotic patients who were diagnosed as CTPV with EHPVO were retrospectively analyzed. Eligible patients were distributed into the anticoagulation group (n = 46) and control group (n = 38). The change of portal vein thrombosis, hepatic decompensation, survival and adverse events were evaluated between the two groups.ResultsThe median follow-up of our patients was 51 months in the anticoagulation group and 44 months in the control group. The progress rate of the portal vein was higher in patients from the control groups (n = 12) than in patients from the anticoagulation group (n = 4, p = 0.008). There was no significant difference between the partial recanalization rate and stable rate between the two groups. Patients in anticoagulation group developed less hepatic decompensation than those in control group (13.0% vs 34.2%, p = 0.021). The Kaplan-Meier curve showed that patients in the anticoagulation group had a better prognosis than patients in the control group (P < 0.022). There were no serious complications due to warfarin treatment.ConclusionFor CTPV cirrhotic patients with EHPVO, anticoagulation with warfarin treatment was effective and safe. Anticoagulants could prevent portal vein thrombosis progression, hepatic decompensation and death. In addition, our results showed little benefit of anticoagulants on thrombosis recanalization.

【 授权许可】

CC BY   
© The Author(s) 2023

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