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Predictors of portal vein thrombosis in virus-related cirrhosis

April's issue of the American Journal of Gastroenterology identifies predictive factors of de novo portal vein thrombosis in virus-related cirrhosis.

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Dr Hitoshi Maruyama from Japan investigated predictive factors and long-term outcomes of de novo portal vein thrombosis in cirrhosis.

The incidence and factors predictive of portal vein thrombosis and prognosis were examined in 150 patients with virus-related cirrhosis but without portal vein thrombosis at baseline.

The team reported that portal vein thrombosis developed in 28% of patients, with cumulative incidence of 13%, 20%, and 38% at 1, 5, and 8–10 years, respectively.

The baseline flow volume in the largest collateral vessel was an independent risk factor for thrombosis.

The natural course of thrombosis was improvement in 47%
American Journal of Gastroenterology

The research team assessed that the cumulative incidence of portal vein thrombosis at 1, 5, and 10 years was significantly higher in patients with the largest collateral vessel velocity 10 cm/s compared with those with velocity 10 cm/s, and higher in patients with volume 400 ml/min compared with those with volume 400 ml/min.

The natural course of thrombosis was improvement in 47%, unchanged in 45%, and worsened in 7%.

The doctors examined that the diameter and flow volume in the largest collateral vessel at the time of thrombus detection were significantly smaller in the improved patients than the others.

The cumulative survival rate was similar between the thrombosis group and non-thrombosis group.

Dr Hitoshi's team commented, "Development of collateral vessels was a significant predictive factor for the occurrence of portal vein thrombosis in virus-induced cirrhosis."

"Spontaneous resolution or unchanged appearance was the most common outcome of thrombosis, which had little influence on prognosis."

Am J Gastroenterol c2013; 108: 568–574
26 April 2013

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