Management of Acute Non-cirrhotic and Non-malignant Portal Vein Thrombosis: A Systematic Review
Background No definitive evidence exists regarding the treatment of acute portal vein thrombosis (PVT). Treatment modalities described include conservative management, anticoagulation, thrombolysis, and thrombectomy. This review examines the impact of such treatment, its outcomes, and the complicati...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Hall, T. C. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2011 |
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| Schlagwörter: |
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| Anmerkung: |
© Société Internationale de Chirurgie 2011 |
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| Übergeordnetes Werk: |
Enthalten in: World Journal of Surgery - Springer-Verlag, 1996, 35(2011), 11 vom: 01. Sept. |
|---|---|
| Übergeordnetes Werk: |
volume:35 ; year:2011 ; number:11 ; day:01 ; month:09 |
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| DOI / URN: |
10.1007/s00268-011-1198-0 |
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SPR003430774 |
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| 520 | |a Background No definitive evidence exists regarding the treatment of acute portal vein thrombosis (PVT). Treatment modalities described include conservative management, anticoagulation, thrombolysis, and thrombectomy. This review examines the impact of such treatment, its outcomes, and the complications resulting from the resultant portal hypertension. Methods A Medline literature search was undertaken using the keywords portal vein thrombosis, anticoagulation, thrombolysis, and thrombectomy. The primary end point was portal vein recanalization. Secondary outcome measures were morbidity and the development of portal hypertension and its sequelae, including variceal bleeding. Data from articles relating to PVT in the context of cirrhosis, malignancy, or liver transplant were excluded. Results Early systemic anticoagulation results in complete portal vein recanalization in 38.3% of cases and partial recanalization in 14.0% of cases. Spontaneous recanalization without treatment can only be expected in up to 16.7% of patients. Frequently this is only when associated with self-limiting underlying pathology and/or minimal thrombus extension. Thrombolysis can be associated with major complications in up to 60% of patients. Conclusions The natural history of acute PVT is poorly described. Spontaneous resolution of acute portal vein thrombosis is uncommon. Early anticoagulation results in a satisfactory rate of recanalization with minimal procedure-associated morbidity. Thrombolysis should be used with caution and only considered if the disease is progressive and signs of mesenteric ischemia are present. Further well-designed trials with precise outcome reporting are needed to improve our understanding of the disease. | ||
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10.1007/s00268-011-1198-0 doi (DE-627)SPR003430774 (SPR)s00268-011-1198-0-e DE-627 ger DE-627 rakwb eng Hall, T. C. verfasserin aut Management of Acute Non-cirrhotic and Non-malignant Portal Vein Thrombosis: A Systematic Review 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background No definitive evidence exists regarding the treatment of acute portal vein thrombosis (PVT). Treatment modalities described include conservative management, anticoagulation, thrombolysis, and thrombectomy. This review examines the impact of such treatment, its outcomes, and the complications resulting from the resultant portal hypertension. Methods A Medline literature search was undertaken using the keywords portal vein thrombosis, anticoagulation, thrombolysis, and thrombectomy. The primary end point was portal vein recanalization. Secondary outcome measures were morbidity and the development of portal hypertension and its sequelae, including variceal bleeding. Data from articles relating to PVT in the context of cirrhosis, malignancy, or liver transplant were excluded. Results Early systemic anticoagulation results in complete portal vein recanalization in 38.3% of cases and partial recanalization in 14.0% of cases. Spontaneous recanalization without treatment can only be expected in up to 16.7% of patients. Frequently this is only when associated with self-limiting underlying pathology and/or minimal thrombus extension. Thrombolysis can be associated with major complications in up to 60% of patients. Conclusions The natural history of acute PVT is poorly described. Spontaneous resolution of acute portal vein thrombosis is uncommon. Early anticoagulation results in a satisfactory rate of recanalization with minimal procedure-associated morbidity. Thrombolysis should be used with caution and only considered if the disease is progressive and signs of mesenteric ischemia are present. Further well-designed trials with precise outcome reporting are needed to improve our understanding of the disease. Portal Vein (dpeaa)DE-He213 Portal Hypertension (dpeaa)DE-He213 Thrombolytic Therapy (dpeaa)DE-He213 Portal Vein Thrombosis (dpeaa)DE-He213 Superior Mesenteric Vein (dpeaa)DE-He213 Garcea, G. aut Metcalfe, M. aut Bilku, D. aut Dennison, A. R. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 35(2011), 11 vom: 01. Sept. (DE-627)SPR003391159 nnns volume:35 year:2011 number:11 day:01 month:09 https://dx.doi.org/10.1007/s00268-011-1198-0 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 35 2011 11 01 09 |
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10.1007/s00268-011-1198-0 doi (DE-627)SPR003430774 (SPR)s00268-011-1198-0-e DE-627 ger DE-627 rakwb eng Hall, T. C. verfasserin aut Management of Acute Non-cirrhotic and Non-malignant Portal Vein Thrombosis: A Systematic Review 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background No definitive evidence exists regarding the treatment of acute portal vein thrombosis (PVT). Treatment modalities described include conservative management, anticoagulation, thrombolysis, and thrombectomy. This review examines the impact of such treatment, its outcomes, and the complications resulting from the resultant portal hypertension. Methods A Medline literature search was undertaken using the keywords portal vein thrombosis, anticoagulation, thrombolysis, and thrombectomy. The primary end point was portal vein recanalization. Secondary outcome measures were morbidity and the development of portal hypertension and its sequelae, including variceal bleeding. Data from articles relating to PVT in the context of cirrhosis, malignancy, or liver transplant were excluded. Results Early systemic anticoagulation results in complete portal vein recanalization in 38.3% of cases and partial recanalization in 14.0% of cases. Spontaneous recanalization without treatment can only be expected in up to 16.7% of patients. Frequently this is only when associated with self-limiting underlying pathology and/or minimal thrombus extension. Thrombolysis can be associated with major complications in up to 60% of patients. Conclusions The natural history of acute PVT is poorly described. Spontaneous resolution of acute portal vein thrombosis is uncommon. Early anticoagulation results in a satisfactory rate of recanalization with minimal procedure-associated morbidity. Thrombolysis should be used with caution and only considered if the disease is progressive and signs of mesenteric ischemia are present. Further well-designed trials with precise outcome reporting are needed to improve our understanding of the disease. Portal Vein (dpeaa)DE-He213 Portal Hypertension (dpeaa)DE-He213 Thrombolytic Therapy (dpeaa)DE-He213 Portal Vein Thrombosis (dpeaa)DE-He213 Superior Mesenteric Vein (dpeaa)DE-He213 Garcea, G. aut Metcalfe, M. aut Bilku, D. aut Dennison, A. R. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 35(2011), 11 vom: 01. Sept. (DE-627)SPR003391159 nnns volume:35 year:2011 number:11 day:01 month:09 https://dx.doi.org/10.1007/s00268-011-1198-0 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 35 2011 11 01 09 |
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10.1007/s00268-011-1198-0 doi (DE-627)SPR003430774 (SPR)s00268-011-1198-0-e DE-627 ger DE-627 rakwb eng Hall, T. C. verfasserin aut Management of Acute Non-cirrhotic and Non-malignant Portal Vein Thrombosis: A Systematic Review 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background No definitive evidence exists regarding the treatment of acute portal vein thrombosis (PVT). Treatment modalities described include conservative management, anticoagulation, thrombolysis, and thrombectomy. This review examines the impact of such treatment, its outcomes, and the complications resulting from the resultant portal hypertension. Methods A Medline literature search was undertaken using the keywords portal vein thrombosis, anticoagulation, thrombolysis, and thrombectomy. The primary end point was portal vein recanalization. Secondary outcome measures were morbidity and the development of portal hypertension and its sequelae, including variceal bleeding. Data from articles relating to PVT in the context of cirrhosis, malignancy, or liver transplant were excluded. Results Early systemic anticoagulation results in complete portal vein recanalization in 38.3% of cases and partial recanalization in 14.0% of cases. Spontaneous recanalization without treatment can only be expected in up to 16.7% of patients. Frequently this is only when associated with self-limiting underlying pathology and/or minimal thrombus extension. Thrombolysis can be associated with major complications in up to 60% of patients. Conclusions The natural history of acute PVT is poorly described. Spontaneous resolution of acute portal vein thrombosis is uncommon. Early anticoagulation results in a satisfactory rate of recanalization with minimal procedure-associated morbidity. Thrombolysis should be used with caution and only considered if the disease is progressive and signs of mesenteric ischemia are present. Further well-designed trials with precise outcome reporting are needed to improve our understanding of the disease. Portal Vein (dpeaa)DE-He213 Portal Hypertension (dpeaa)DE-He213 Thrombolytic Therapy (dpeaa)DE-He213 Portal Vein Thrombosis (dpeaa)DE-He213 Superior Mesenteric Vein (dpeaa)DE-He213 Garcea, G. aut Metcalfe, M. aut Bilku, D. aut Dennison, A. R. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 35(2011), 11 vom: 01. Sept. (DE-627)SPR003391159 nnns volume:35 year:2011 number:11 day:01 month:09 https://dx.doi.org/10.1007/s00268-011-1198-0 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 35 2011 11 01 09 |
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10.1007/s00268-011-1198-0 doi (DE-627)SPR003430774 (SPR)s00268-011-1198-0-e DE-627 ger DE-627 rakwb eng Hall, T. C. verfasserin aut Management of Acute Non-cirrhotic and Non-malignant Portal Vein Thrombosis: A Systematic Review 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background No definitive evidence exists regarding the treatment of acute portal vein thrombosis (PVT). Treatment modalities described include conservative management, anticoagulation, thrombolysis, and thrombectomy. This review examines the impact of such treatment, its outcomes, and the complications resulting from the resultant portal hypertension. Methods A Medline literature search was undertaken using the keywords portal vein thrombosis, anticoagulation, thrombolysis, and thrombectomy. The primary end point was portal vein recanalization. Secondary outcome measures were morbidity and the development of portal hypertension and its sequelae, including variceal bleeding. Data from articles relating to PVT in the context of cirrhosis, malignancy, or liver transplant were excluded. Results Early systemic anticoagulation results in complete portal vein recanalization in 38.3% of cases and partial recanalization in 14.0% of cases. Spontaneous recanalization without treatment can only be expected in up to 16.7% of patients. Frequently this is only when associated with self-limiting underlying pathology and/or minimal thrombus extension. Thrombolysis can be associated with major complications in up to 60% of patients. Conclusions The natural history of acute PVT is poorly described. Spontaneous resolution of acute portal vein thrombosis is uncommon. Early anticoagulation results in a satisfactory rate of recanalization with minimal procedure-associated morbidity. Thrombolysis should be used with caution and only considered if the disease is progressive and signs of mesenteric ischemia are present. Further well-designed trials with precise outcome reporting are needed to improve our understanding of the disease. Portal Vein (dpeaa)DE-He213 Portal Hypertension (dpeaa)DE-He213 Thrombolytic Therapy (dpeaa)DE-He213 Portal Vein Thrombosis (dpeaa)DE-He213 Superior Mesenteric Vein (dpeaa)DE-He213 Garcea, G. aut Metcalfe, M. aut Bilku, D. aut Dennison, A. R. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 35(2011), 11 vom: 01. Sept. (DE-627)SPR003391159 nnns volume:35 year:2011 number:11 day:01 month:09 https://dx.doi.org/10.1007/s00268-011-1198-0 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 35 2011 11 01 09 |
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10.1007/s00268-011-1198-0 doi (DE-627)SPR003430774 (SPR)s00268-011-1198-0-e DE-627 ger DE-627 rakwb eng Hall, T. C. verfasserin aut Management of Acute Non-cirrhotic and Non-malignant Portal Vein Thrombosis: A Systematic Review 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background No definitive evidence exists regarding the treatment of acute portal vein thrombosis (PVT). Treatment modalities described include conservative management, anticoagulation, thrombolysis, and thrombectomy. This review examines the impact of such treatment, its outcomes, and the complications resulting from the resultant portal hypertension. Methods A Medline literature search was undertaken using the keywords portal vein thrombosis, anticoagulation, thrombolysis, and thrombectomy. The primary end point was portal vein recanalization. Secondary outcome measures were morbidity and the development of portal hypertension and its sequelae, including variceal bleeding. Data from articles relating to PVT in the context of cirrhosis, malignancy, or liver transplant were excluded. Results Early systemic anticoagulation results in complete portal vein recanalization in 38.3% of cases and partial recanalization in 14.0% of cases. Spontaneous recanalization without treatment can only be expected in up to 16.7% of patients. Frequently this is only when associated with self-limiting underlying pathology and/or minimal thrombus extension. Thrombolysis can be associated with major complications in up to 60% of patients. Conclusions The natural history of acute PVT is poorly described. Spontaneous resolution of acute portal vein thrombosis is uncommon. Early anticoagulation results in a satisfactory rate of recanalization with minimal procedure-associated morbidity. Thrombolysis should be used with caution and only considered if the disease is progressive and signs of mesenteric ischemia are present. Further well-designed trials with precise outcome reporting are needed to improve our understanding of the disease. Portal Vein (dpeaa)DE-He213 Portal Hypertension (dpeaa)DE-He213 Thrombolytic Therapy (dpeaa)DE-He213 Portal Vein Thrombosis (dpeaa)DE-He213 Superior Mesenteric Vein (dpeaa)DE-He213 Garcea, G. aut Metcalfe, M. aut Bilku, D. aut Dennison, A. R. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 35(2011), 11 vom: 01. Sept. (DE-627)SPR003391159 nnns volume:35 year:2011 number:11 day:01 month:09 https://dx.doi.org/10.1007/s00268-011-1198-0 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 35 2011 11 01 09 |
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10.1007/s00268-011-1198-0 |
| title_sort |
management of acute non-cirrhotic and non-malignant portal vein thrombosis: a systematic review |
| title_auth |
Management of Acute Non-cirrhotic and Non-malignant Portal Vein Thrombosis: A Systematic Review |
| abstract |
Background No definitive evidence exists regarding the treatment of acute portal vein thrombosis (PVT). Treatment modalities described include conservative management, anticoagulation, thrombolysis, and thrombectomy. This review examines the impact of such treatment, its outcomes, and the complications resulting from the resultant portal hypertension. Methods A Medline literature search was undertaken using the keywords portal vein thrombosis, anticoagulation, thrombolysis, and thrombectomy. The primary end point was portal vein recanalization. Secondary outcome measures were morbidity and the development of portal hypertension and its sequelae, including variceal bleeding. Data from articles relating to PVT in the context of cirrhosis, malignancy, or liver transplant were excluded. Results Early systemic anticoagulation results in complete portal vein recanalization in 38.3% of cases and partial recanalization in 14.0% of cases. Spontaneous recanalization without treatment can only be expected in up to 16.7% of patients. Frequently this is only when associated with self-limiting underlying pathology and/or minimal thrombus extension. Thrombolysis can be associated with major complications in up to 60% of patients. Conclusions The natural history of acute PVT is poorly described. Spontaneous resolution of acute portal vein thrombosis is uncommon. Early anticoagulation results in a satisfactory rate of recanalization with minimal procedure-associated morbidity. Thrombolysis should be used with caution and only considered if the disease is progressive and signs of mesenteric ischemia are present. Further well-designed trials with precise outcome reporting are needed to improve our understanding of the disease. © Société Internationale de Chirurgie 2011 |
| abstractGer |
Background No definitive evidence exists regarding the treatment of acute portal vein thrombosis (PVT). Treatment modalities described include conservative management, anticoagulation, thrombolysis, and thrombectomy. This review examines the impact of such treatment, its outcomes, and the complications resulting from the resultant portal hypertension. Methods A Medline literature search was undertaken using the keywords portal vein thrombosis, anticoagulation, thrombolysis, and thrombectomy. The primary end point was portal vein recanalization. Secondary outcome measures were morbidity and the development of portal hypertension and its sequelae, including variceal bleeding. Data from articles relating to PVT in the context of cirrhosis, malignancy, or liver transplant were excluded. Results Early systemic anticoagulation results in complete portal vein recanalization in 38.3% of cases and partial recanalization in 14.0% of cases. Spontaneous recanalization without treatment can only be expected in up to 16.7% of patients. Frequently this is only when associated with self-limiting underlying pathology and/or minimal thrombus extension. Thrombolysis can be associated with major complications in up to 60% of patients. Conclusions The natural history of acute PVT is poorly described. Spontaneous resolution of acute portal vein thrombosis is uncommon. Early anticoagulation results in a satisfactory rate of recanalization with minimal procedure-associated morbidity. Thrombolysis should be used with caution and only considered if the disease is progressive and signs of mesenteric ischemia are present. Further well-designed trials with precise outcome reporting are needed to improve our understanding of the disease. © Société Internationale de Chirurgie 2011 |
| abstract_unstemmed |
Background No definitive evidence exists regarding the treatment of acute portal vein thrombosis (PVT). Treatment modalities described include conservative management, anticoagulation, thrombolysis, and thrombectomy. This review examines the impact of such treatment, its outcomes, and the complications resulting from the resultant portal hypertension. Methods A Medline literature search was undertaken using the keywords portal vein thrombosis, anticoagulation, thrombolysis, and thrombectomy. The primary end point was portal vein recanalization. Secondary outcome measures were morbidity and the development of portal hypertension and its sequelae, including variceal bleeding. Data from articles relating to PVT in the context of cirrhosis, malignancy, or liver transplant were excluded. Results Early systemic anticoagulation results in complete portal vein recanalization in 38.3% of cases and partial recanalization in 14.0% of cases. Spontaneous recanalization without treatment can only be expected in up to 16.7% of patients. Frequently this is only when associated with self-limiting underlying pathology and/or minimal thrombus extension. Thrombolysis can be associated with major complications in up to 60% of patients. Conclusions The natural history of acute PVT is poorly described. Spontaneous resolution of acute portal vein thrombosis is uncommon. Early anticoagulation results in a satisfactory rate of recanalization with minimal procedure-associated morbidity. Thrombolysis should be used with caution and only considered if the disease is progressive and signs of mesenteric ischemia are present. Further well-designed trials with precise outcome reporting are needed to improve our understanding of the disease. © Société Internationale de Chirurgie 2011 |
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Management of Acute Non-cirrhotic and Non-malignant Portal Vein Thrombosis: A Systematic Review |
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Garcea, G. Metcalfe, M. Bilku, D. Dennison, A. R. |
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