Is there a role for anticoagulants in portal vein thrombosis management in cirrhotic patients?
BACKGROUND
Portal vein thrombosis (PVT) is one of the principal complications of liver cirrhosis. The estimated prevalence is < 1% in patients with a compensated disease; this increases to 8 - 25% in candidates for liver transplantation. Many determinants may influence PVT clinical presentation and its outcome.


METHODS
We report the actual knowledge regarding management of PVT and analyze the different therapeutic approaches, focusing particularly on the use of anticoagulants and their implications in the complex clinical setting of liver cirrhosis. We also describe the possible available preemptive strategies, as an early prophylactic management based on clinical, biochemical or radiological parameters may in the future reduce PVT incidence and complications, ameliorating patients' outcome.


RESULTS
The importance of an accurate PVT diagnosis and its implications in PVT management; a description of the different available therapeutic tools, their efficacy and their possible risks in different typologies of patients; the principal elements to choose a correct individualized therapy for PVT patients.


CONCLUSIONS
The challenge for clinicians is the early identification of PVT, in order to prevent frightening complications, such as variceal bleeding or mesenteric infarction, and to provide the best therapeutic management.
Ponziani
Francesca Romana
FR
Catholic University of Rome, Department of Internal Medicine, Largo A. Gemelli 8, 00168 Rome, Italy. francesca.ponziani@yahoo.it
Zocco
Maria Assunta
MA
Tortora
Annalisa
A
Gasbarrini
Antonio
A
D000925:Anticoagulants / Q000627:therapeutic use*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery; D016031:Liver Transplantation; D011169:Portal Vein / Q000473:pathology*; D013927:Thrombosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
D000925:Anticoagulants