Acute non-cirrhotic non-tumoral portal vein thrombosis
Abstract
Aim: to consider the options for the course, diagnosis and treatment of acute portal vein thrombosis.
Materials and methods: PubMed, RSCI, Google Scholar search engine, and reference lists were used to search for scientific publications. Articles corresponding to the purpose of the review were selected for the period from 1999 to 2021 according to the following terms: “acute portal vein thrombosis”, “acute mesenteric ischemia”, “pathogenesis”, “diagnosis”, “treatment”. Inclusion criteria were limited to acute portal vein thrombosis in patients without cirrhosis and liver malignancy.
Results and conclusions. Acute portal vein thrombosis in patients without cirrhosis and liver malignancy is rare. The main role in the diagnosis is played by imaging methods (duplex ultrasound scanning, multislice computed and magnetic resonance imaging). Timely diagnosis is necessary to prevent complications such as intestinal infarction, sepsis, cavernous transformation of the portal vein. Treatment of acute portal vein thrombosis consists in recanalization of the thrombosed vein, prevention of thrombus spread to mesenteric vessels and intestinal infarction, as well as correction of concomitant diseases.
Supporting agencies: The study was supported by the Russian Science Foundation grant № 22-25-20016, https://rscf.ru/pro- ject/22-25-20016/
About the Authors
D. V. Belov
South-Urals State Medical University; Federal State Budgetary Institution “Federal Center for Cardiovascular Surgery” of the Ministry of Health of the Russian Federation (Chelyabinsk)
Russian Federation
Russian Federation
Chelyabinsk
A. A. Fokin
South-Urals State Medical University
Russian Federation
Russian Federation
Chelyabinsk
O. S. Abramovskikh
South-Urals State Medical University
Russian Federation
Russian Federation
Chelyabinsk
N. A. Danko
Federal State Budgetary Institution “Federal Center for Cardiovascular Surgery” of the Ministry of Health of the Russian Federation (Chelyabinsk)
Russian Federation
Russian Federation
Chelyabinsk
References
1. Hernández-Gea, V. Current knowledge in pathophysiology and management of Budd-Chiari syndrome and non-cirrhotic non-tumoral splanchnic vein thrombosis / V. Hernández-Gea, A. De Gottardi, F. W. G. Leebeek [et al.] // J. Hepatol. – 2019. – Т. 71, № 1. – С. 175–199.
2. Northup, P. G. Vascular Liver Disorders, Portal Vein Thrombosis, and Procedural Bleeding in Patients With Liver Disease: 2020 Practice Guidance by the American Association for the Study of Liver Diseases / P. G. Northup, J. C. Garcia-Pagan, G. Garcia-Tsao [et al.] // Hepatology. – 2021. – Т. 73, № 1. – С. 366–413.
3. Plessier, A. Acute portal vein thrombosis unrelated to cirrhosis: A prospective multicenter follow-up study / A. Plessier, S. Darwish-Murad, M. Hernandez-Guerra [et al.] // Hepatology. – 2010. – Т. 51, № 1. – С. 210–218.
4. Ortiz López, D. Portal thrombosis in a patient with SARS-CoV-2 infection / D. Ortiz López, A. Puente Fernández, I. Ramos Gómez [et al.] // Rev. Esp. Enferm. Dig. – 2021. – Т. 113, № 12. – С. 840–841.
5. Keil, R. Acute portal vein thrombosis in noncirrhotic patients — different prognoses based on presence of inflammatory markers: a long-term multicenter retrospective analysis / R. Keil, J. Koželuhová, J. Dolina [et al.] // Scand. J. Gastroenterol. – 2019. – Т. 54, № 11. – С. 1379–1384.
6. Primignani, M. Portal vein thrombosis, revisited / M. Primignani // Dig. Liver Dis. – 2010. – Т. 42, № 3. – С. 163–170.
7. Seijo, S. Noncirrhotic nontumoral portal vein thrombosis / S. Seijo, A. Plessier // Clin. Liver Dis. (Hoboken). – 2014. – Т. 3, № 6. – С. 118–121.
8. Benmassaoud, A. A stepwise thrombolysis regimen in the management of acute portal vein thrombosis in patients with evidence of intestinal ischaemia / A. Benmassaoud, L. Al Rubaiy, D. Yu [et al.] // Aliment. Pharmacol. Ther. – 2019. – Т. 50, № 9. – С. 1049–1058.
9. Nuzzo, A. Predictive Factors of Intestinal Necrosis in Acute Mesenteric Ischemia: Prospective Study from an Intestinal Stroke Center / A. Nuzzo, L. Maggiori, M. Ronot [et al.] // Am. J. Gastroenterol. – 2017. – Т. 112, № 4. – С. 597–605.
10. Jha, R. C. Portal vein thrombosis: Imaging the spectrum of disease with an emphasis on MRI features / R. C. Jha, S. S. Khera, A. D. Kalaria // AJR Am. J. Roentgenol. – 2018. – Т. 211, № 1. – С. 14–24.
11. Björck, M. Editor's Choice Management of the Diseases of Mesenteric Arteries and Veins Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS) / M. Björck, M. Koelemay, S. Acosta [et al.] // Eur. J. Vasc. Endovasc. Surg. – 2017. – Т. 53, № 4. – С. 460–510.
12. Wu, M. Update on Management of Portal Vein Thrombosis and the Role of Novel Anticoagulants / M. Wu, M. Schuster, M. Tadros // J. Clin. Transl. Hepatol. – 2019. – Т. 7, № 2. – С. 154–164.
13. Martinez, M. Treatment of acute portal vein thrombosis by nontraditional anticoagulation / M. Martinez, A. Tandra, R. Vuppalanchi // Hepatology. – 2014. – Т. 60, № 1. – С. 425–426.
14. Irawan, H. Combination of modified Sugiura technique and proximal splenorenal shunt for the management of portal vein thrombosis in noncirrhotic portal hypertension / H. Irawan, I. M. Mulyawan // Clin. Exp. Gastroenterol. – 2019. – Т. 12. – С. 149–156.
15. Loffredo, L. Effects of Anticoagulants in Patients With Cirrhosis and Portal Vein Thrombosis: A Systematic Review and Meta-analysis / L. Loffredo, D. Pastori, A. Farcomeni [et al.] // Gastroenterology. – 2017. – Т. 153, № 2. – С. 480–487.
16. Turnes, J. Portal hypertension-related complications after acute portal vein thrombosis: impact of early anticoagulation / J. Turnes, J. C. G. Pagan, M. Gonzalez [et al.] // Clin. Gastroenterol. Hepatol. – 2008. – Т. 6, № 12. – С. 1412–1417.
17. Naymagon, L. The efficacy and safety of direct oral anticoagulants in noncirrhotic portal vein thrombosis / L. Naymagon, D. Tremblay, N. Zubizarreta [et al.] // Blood Adv. – 2020. – Т. 4, № 4. – С. 655–666.
18. Priyanka, P. Newer Oral Anticoagulants in the Treatment of Acute Portal Vein Thrombosis in Patients with and without Cirrhosis / P. Priyanka, J. T. Kupec, M. Krafft [et al.] // Int. J. Hepatol. – 2018. – Т. 2018. – С. 8432781.
19. Hollingshead, M. Transcatheter thrombolytic therapy for acute mesenteric and portal vein thrombosis / M. Hollingshead, C. T. Burke, M. A. Mauro [et al.] // J. Vasc. Interv. Radiol. – 2005. – Т. 16, № 5. – С. 651–661.
20. Semiz-Oysu, A. Interventional radiological management of prehepatic obstruction of [corrected] the splanchnic venous system / A. Semiz-Oysu, I. Keussen, W. Cwikiel // Cardiovasc. Intervent. Radiol. – 2007. – Т. 30, № 4. – С. 95.
21. Yang, S. Multidisciplinary stepwise management strategy for acute superior mesenteric venous thrombosis: an intestinal stroke center experience / S. Yang, X. Fan, W. Ding [et al.] // Thromb. Res. – 2015. – Т. 135, № 1. – С. 36–45.
22. Takahashi, N. Percutaneous transhepatic mechanical thrombectomy for acute mesenteric venous thrombosis / N. Takahashi, K. Kuroki, K. Yanaga // J. Endovasc. Ther. – 2005. – Т. 2, № 4. – С. 508–511.
23. Ganger, D. R. Transjugular intrahepatic portosystemic shunt (TIPS) for Budd-Chiari syndrome or portal vein thrombosis: review of indications and problems / D. R. Ganger, J. B. Klapman, V. McDonald [et al.] // Am. J. Gastroenterol. – 1999. – Т. 94, № 3. – С. 603–618.
24. Wang, C. Y. Agitation thrombolysis combined with catheter-directed thrombolysis for the treatment of non-cirrhotic acute portal vein thrombosis / C. Y. Wang, L. Q. Wei, H. Z. Niu [et al.] // World J. Gastroenterol. – 2018. – Т. 24, № 39. – С. 4482–4488.
25. Wang, M. Q. Acute symptomatic mesenteric venous thrombosis: treatment by catheterdirected thrombolysis with transjugular intrahepatic route / M. Q. Wang, F. Y. Liu, F. Duan [et al.] // Abdom. Imaging. – 2011. – Т. 36, № 4. – С. 390–398.
26. EASL Clinical Practice Guidelines: Vascular diseases of the liver / European Association for the Study of the Liver // J. Hepatol. – 2016. – Т. 64, № 1. – С. 179–202.
27. Som, R. Portal vein thrombosis following laparoscopic gastric plication / R. Som, S. Rikabi, A. Chang [et al.] // Ann. R Coll. Surg. Engl. – 2017. – Т. 99, № 1. – С. 6–7.
Review
For citations:
Belov D.V., Fokin A.A., Abramovskikh O.S., Danko N.A. Acute non-cirrhotic non-tumoral portal vein thrombosis. Title in english. 2023;18(2):3-6. (In Russ.)
Views:
205
Email this article 