Increased portal vein diameter is predictive of portal vein thrombosis development in patients with liver cirrhosis

Background: Cirrhotic patients with portal vein thrombosis (PVT) may have a high risk of hepatic decompensation and increased mortality. This study aimed to investigate if increased portal vein diameter is associated with PVT development. Methods: A total of 174 cirrhotic patients were enrolled between February 1 and August 31, 2017. All participants were divided into PVT (n=62) and non-PVT (n=112) groups based on the thrombus that was detected by ultrasonography and confirmed by computed tomography angiography (CTA). Results: The study participants, aged 54.7 +/- 10.5 years (PVT) and 55.8 +/- 11.6 years (non-PVT), were included in this analysis. The Child-Pugh score of PVT or non-PVT was 6.6 +/- 1.3 and 5.8 +/- 0.9, respectively. Hepatitis B virus (HBV) is the primary etiological agent of cirrhosis. Logistic regression, receiver operating characteristic (ROC), and nomograph analysis designated portal diameter as the strongest independent risk factor for predicting PVT development [odds ratio (OR): 3.96, area under the ROC curve (AUC): 0.88; P 0.01], and the cutoff with predictive value for PVT development was 12.5 mm. No differences were observed in the overall survival (OS) in cirrhosis with or without PVT or stratifying on portal diameter based on the cutoff value. Conclusions: Increased portal diameter is associated with an increased risk of PVT development. Patients with cirrhosis and increased portal diameter are a high-risk subgroup that may need thromboprophylaxis.

Automated summary

In cirrhotic patients with portal vein thrombosis (PVT), an increased portal vein diameter is associated with a higher risk of PVT development. The portal diameter is the strongest independent risk factor for predicting PVT development, with a cutoff value of 12.5 mm. Patients with cirrhosis and an increased portal diameter may require thromboprophylaxis as a high-risk subgroup.