Balloon Occlusion Retrograde Transvenous Obliteration of Gastric Varices in Two Non-Cirrhotic Patients with Portal Vein Thrombosis

Background and aims. This study aimed to detect exhaled nitric oxide (eNO) level in cirrhotic patients and explore the correlation between eNO levels and the severity of cirrhosis. Methods. Patients were enrolled to analyze the relationship of eNO with noncirrhosis, cirrhosis, and complications of decompensated cirrhosis. We explored the potential predictive values of eNO in different states of cirrhosis. Results. The eNO levels were significantly increased in cirrhotic patients compared with noncirrhotic patients (14 (10–18) vs 8 (6–13) ppb, P<0.001). The eNO level was increased in those with ascites (15 (14–22) vs 13 (10–18) ppb, P=0.026), with portal vein thrombosis (19.5 (11.75–22) vs 13.5 (10–17) ppb, P=0.032), or with the mucosal red-color sign of esophageal and gastric varices (EGV) (16.5 (10–21.75) vs 13 (10–14.75) ppb, P=0.041). Among cirrhotic patients undergoing hepatic venous pressure gradient (HVPG) measurement, the eNO level was significantly increased in the high-HVPG group (HVPG >12 mm Hg) compared with the low-HVPG group (6 mm Hg ≤ HVPG ≤ 12 mm Hg) (15 (11.75–19.25) vs 10 (8–14) ppb, P=0.011). Conclusions. The eNO level was increased in cirrhotic patients, especially in those complicated with ascites, portal vein thrombosis, mucosal red-color sign of varices, and high HVPG.

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Portal vein thrombosis in cirrhotic patients - it is always the small pieces that make the big picture

World Journal of Gastroenterology ◽

10.3748/wjg.v24.i39.4419 ◽

2018 ◽

Vol 24 (39) ◽

pp. 4419-4427 ◽

Cited By ~ 5

Author(s):

Irina Gîrleanu ◽

Anca Trifan ◽

Carol Stanciu ◽

Cătălin Sfarti

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Vein Thrombosis ◽

Big Picture ◽

Cirrhotic Patients

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Portal vein thrombosis in hepatitis C virus-related cirrhotic patients: Prevalence and clinical characteristics in an Egyptian cohort

Tropical Doctor ◽

10.1177/0049475521998509 ◽

2021 ◽

pp. 004947552199850

Author(s):

Omkolsoum Alhaddad ◽

Maha Elsabaawy ◽

Omar Elshaaraawy ◽

Mohamed Elhalawany ◽

Mohamed Mohamed Houseni ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Clinical Characteristics ◽

Abdominal Ultrasound ◽

Focal Lesion ◽

Vein Thrombosis ◽

Doppler Study ◽

Cirrhotic Patients

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.

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Efficacy of Transjugular Intrahepatic Portosystemic Shunt to Prevent Total Portal Vein Thrombosis in Cirrhotic Patients Awaiting for Liver Transplantation

Transplantation Proceedings ◽

10.1016/j.transproceed.2012.09.050 ◽

2012 ◽

Vol 44 (9) ◽

pp. 2603-2605 ◽

Cited By ~ 25

Author(s):

D. D'Avola ◽

J.I. Bilbao ◽

G. Zozaya ◽

F. Pardo ◽

F. Rotellar ◽

...

Keyword(s):

Liver Transplantation ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Transjugular Intrahepatic Portosystemic Shunt ◽

Portosystemic Shunt ◽

Vein Thrombosis ◽

Intrahepatic Portosystemic Shunt ◽

Cirrhotic Patients

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Covered TIPS versus endoscopic band ligation plus propranolol for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis: a randomised controlled trial

Gut ◽

10.1136/gutjnl-2017-314634 ◽

2017 ◽

Vol 67 (12) ◽

pp. 2156-2168 ◽

Cited By ~ 38

Author(s):

Yong Lv ◽

Xingshun Qi ◽

Chuangye He ◽

Zhengyu Wang ◽

Zhanxin Yin ◽

...

Keyword(s):

Portal Hypertension ◽

Adverse Events ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Decompensated Cirrhosis ◽

Covered Stents ◽

Band Ligation ◽

Vein Thrombosis ◽

Cirrhotic Patients ◽

Endoscopic Band Ligation

ObjectiveLimited data are available on the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis (PVT). This study aimed to compare transjugular intrahepatic portosystemic shunt (TIPS) with covered stents versus endoscopic band ligation (EBL) plus propranolol for the prevention of variceal rebleeding among patients with cirrhosis and PVT.DesignConsecutive cirrhotic patients (94% Child-Pugh class A or B) with PVT who had variceal bleeding in the past 6 weeks were randomly assigned to TIPS group (n=24) or EBL plus propranolol group (EBL+drug, n=25), respectively. Primary endpoint was variceal rebleeding. Secondary endpoints included survival, overt hepatic encephalopathy (OHE), portal vein recanalisation and rethrombosis, other complications of portal hypertension and adverse events.ResultsDuring a median follow-up of 30 months in both groups, variceal rebleeding was significantly less frequent in the TIPS group (15% vs 45% at 1 year and 25% vs 50% at 2 years, respectively; HR=0.28, 95% CI 0.10 to 0.76, p=0.008), with a significantly higher portal vein recanalisation rate (95% vs 70%; p=0.03) and a relatively lower rethrombosis rate (5% vs 33%; p=0.06) compared with the EBL+drug group. There were no statistically significant differences in survival (67% vs 84%; p=0.152), OHE (25% vs 16%; p=0.440), other complications of portal hypertension and adverse events between groups.ConclusionCovered TIPS placement in patients with PVT and moderately decompensated cirrhosis was more effective than EBL combined with propranolol for the prevention of rebleeding, with a higher probability of PVT resolution without increasing the risk of OHE and adverse effects, but this benefit did not translate into improved survival.Trial registration numberClinicalTrials.gov: NCT01326949.

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The impact of portal vein thrombosis on the prognosis and liver function of nonmalignant cirrhotic patients

Scandinavian Journal of Gastroenterology ◽

10.1080/00365521.2018.1503327 ◽

2018 ◽

Vol 53 (10-11) ◽

pp. 1340-1346 ◽

Cited By ~ 1

Author(s):

Kei Endo ◽

Takayoshi Oikawa ◽

Keisuke Kakisaka ◽

Akio Tamura ◽

Shigeru Ehara ◽

...

Keyword(s):

Liver Function ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Vein Thrombosis ◽

Cirrhotic Patients ◽

The Impact

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Pyogenic Portal Vein Thrombosis as a Reservoir of Persistent Septicemia after Cyanoacrylate Injection for Bleeding Gastric Varices

Digestion ◽

10.1159/000175360 ◽

2008 ◽

Vol 78 (2-3) ◽

pp. 139-143 ◽

Cited By ~ 16

Author(s):

Chen-Jung Chang ◽

Yih-Tsong Shiau ◽

Te-Li Chen ◽

Ming-Chih Hou ◽

Chih-Hao Sun ◽

...

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Gastric Varices ◽

Vein Thrombosis

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Low Molecular Weight Heparin in Portal Vein Thrombosis of Cirrhotic Patients: Only Therapeutic Purposes?

The Scientific World JOURNAL ◽

10.1155/2014/895839 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Raffaele Licinio ◽

Mariabeatrice Principi ◽

Giuseppe Losurdo ◽

Nicola Maurizio Castellaneta ◽

Enzo Ierardi ◽

...

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

High Rate ◽

Low Molecular Weight ◽

Vein Thrombosis ◽

If Current ◽

General Feeling ◽

Cirrhotic Patients ◽

Current Guidelines ◽

Hepatic Synthesis

Cirrhosis has always been regarded as hemorrhagic coagulopathy caused by the reduction in the hepatic synthesis of procoagulant proteins. However, with the progression of liver disease, the cirrhotic patient undergoes a high rate of thrombotic phenomena in the portal venous system. Although the progression of liver failure produces a reduction in the synthesis of anticoagulant molecules, a test able to detect the patients with hemostatic balance shifting towards hypercoagulability has not yet been elaborated. The need of treatment and/or prophylaxis of cirrhotic patients is demonstrated by the increased mortality, the risk of bleeding from esophageal varices, and the mortality of liver transplantation, when portal vein thrombosis (PVT) occurs even if current guidelines do not give indications about PVT treatment in cirrhosis. In view of the general feeling that the majority of cirrhotic patients at an advanced stage may be in a procoagulant condition (suggested by the sharp increase in the prevalence of PVT), it is presumable that a prophylaxis of this population could be of benefit. The safety and the efficacy of prophylaxis and treatment with enoxaparin in patients with cirrhosis demonstrated by a single paper suggest this option only in controlled trials and, currently, there are no sufficient evidences for a recommendation in the clinical practice.

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