4.7 Review

Portal Vein Thrombosis in the Setting of Cirrhosis: A Comprehensive Review

Journal

JOURNAL OF CLINICAL MEDICINE
Volume 11, Issue 21, Pages -

Publisher

MDPI
DOI: 10.3390/jcm11216435

Keywords

portal hypertension; cirrhosis; portal vein thrombosis; anticoagulation; transjugular intrahepatic portosystemic shunt

Funding

  1. Carlos III Health Institute [PI20/01258]
  2. Spanish Association for Study of the Liver (AEEH, Juan Cordoba grant)

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This article comprehensively reviews the pathophysiology, clinical features, diagnosis, and treatment of portal vein thrombosis in patients with cirrhosis. Despite being a common complication in cirrhotic patients, the impact of portal vein thrombosis on hepatic decompensation and overall mortality is still debated. The lack of large prospective observational studies and randomized trials explain the heterogeneous recommendations in current guidelines.
Portal vein thrombosis constitutes the most common thrombotic event in patients with cirrhosis, with increased rates in the setting of advanced liver disease. Despite being a well-known complication of cirrhosis, the contribution of portal vein thrombosis to hepatic decompensation and overall mortality is still a matter of debate. The incorporation of direct oral anticoagulants and new radiological techniques for portal vein recanalization have expanded our therapeutic arsenal. However, the lack of large prospective observational studies and randomized trials explain the heterogenous diagnostic and therapeutic recommendations of current guidelines. This article seeks to make a comprehensive review of the pathophysiology, clinical features, diagnosis, and treatment of portal vein thrombosis in patients with cirrhosis.

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