Carvedilol versus propranolol effect in the primary prophylaxis  of variceal bleeding in cirrhotic patients with portal vein thrombosis

Author(s):  
Irina Girleanu
2021 ◽  
Author(s):  
Zhanjuan Gao ◽  
Jingrun Zhao ◽  
Xiaofeng Liu ◽  
Senlin Li ◽  
Minghui Wang ◽  
...  

Abstract Background and Aims: The association between prognosis of variceal bleeding and portal vein thrombosis (PVT) is unclear. In this multicentre study, we determined the effect of PVT on rebleeding and mortality in patients with acute variceal bleeding (AVB) after oesophageal variceal band ligation (EVL).Methods: Cirrhotic patients with AVB who had undergone EVL were included. The patients were allocated to either the PVT group or the control cirrhotic group (CCG) based on the presence or absence of PVT. One-year rebleeding episodes and mortality after EVL were recorded.Results: A total of 218 cirrhotic patients with AVB from 3 centres were included. Patients with PVT had a higher rate of 14-day and 6-week rebleeding than those without PVT (14-day: 8.26% vs. 1.83%, p = 0.03; 6-week: 11.92% vs. 1.83%, p = 0.003). The rates of 5-day failure (3.67% vs. 0.92%, p = 0.175), 1-year rebleeding (21.10% vs. 20.18%, p = 0.867), and 14-day, 6-week, and 1-year mortality were similar between the groups (14-day: 3.67% vs. 0.92%, p = 0.175; 6-week: 3.67% vs. 0.92%, p = 0.175; 1-year: 3.67% vs. 1.83%, p = 0.408). The Child-Pugh class [p = 0.022, hazard ratio (HR): 1.453; 95% confidence interval (CI): 1.056–1.998], PVT (p = 0.050, HR: 4.622, 95% CI: 0.999–21.395), albumin < 30 g/L (p = 0.023, HR: 5.886, 95% CI: 1.272–27.245), and number of bands (p = 0.010, HR: 1.207, 95% CI: 1.046–1.393) were identified as the predictors for 14-day rebleeding; the multivariate analysis revealed only the number of bands (p = 0.009, HR: 1.247, 95% CI: 1.056–1.473) as the independent factor. PVT (p = 0.012, HR: 6.732, 95% CI: 1.519–29.835) and albumin < 30 g/L (p = 0.027, HR: 3.643, 95% CI: 1.160–11.441) were identified as predictors for 6-week rebleeding; however, only PVT (p = 0.015, HR: 6.380, 95% CI: 1.427–28.515) was found to be the independent factor in the multivariate analysis. Further analysis showed that superior mesenteric vein (SMV) thrombosis is the only risk factor predicting 6-week rebleeding in patients with PVT (p = 0.032, HR: 3.405, 95% CI: 1.112–10.429). Conclusions: PVT was associated with high 14-day and 6-week rebleeding in patients after EVL. SMV thrombosis was the only risk factor for 6-week rebleeding in patients with PVT. High albumin levels may serve as a protective factor for the 14-day and 6-week rebleeding risk. PVT was not responsible for mortality after EVL during 1-year follow-up.


2010 ◽  
Vol 6 (1) ◽  
pp. 93-94 ◽  
Author(s):  
Xingshun Qi ◽  
Guohong Han ◽  
Ming Bai ◽  
Shanshan Yuan ◽  
Daiming Fan

2018 ◽  
Vol 24 (39) ◽  
pp. 4419-4427 ◽  
Author(s):  
Irina Gîrleanu ◽  
Anca Trifan ◽  
Carol Stanciu ◽  
Cătălin Sfarti

2021 ◽  
pp. 004947552199850
Author(s):  
Omkolsoum Alhaddad ◽  
Maha Elsabaawy ◽  
Omar Elshaaraawy ◽  
Mohamed Elhalawany ◽  
Mohamed Mohamed Houseni ◽  
...  

Portal vein thrombosis is a catastrophe not uncommonly complicating hepatitis C virus-related liver cirrhosis. To estimate its prevalence and clinical characteristics, we investigated 1000 cirrhotic patients by abdominal ultrasound or Doppler study at least. Portal vein thrombosis was found in 21.6%, of whom 157 (72.7%) had malignancy. Complete portal vein thrombosis was found in 70.4%. Half of all these patients had at least one episode of portal hypertensive bleeding, a third had abdominal pain and a quarter presented with jaundice. Portal bilopathy was diagnosed in two cases (0.9%). There was significant association between severity of liver disease, ascites, male gender and site of segmental focal lesion and portal vein thrombosis.


Sign in / Sign up

Export Citation Format

Share Document