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Portal vein thrombosis

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https://www.readbyqxmd.com/read/28515596/balloon-occluded-retrograde-transvenous-obliteration-for-bleeding-gastric-varices-eyes-see-what-the-mind-knows
#1
Pushpinder S Khera, Lee Myungsu, Choi Joonsung
Approximately one in six patients with portal hypertension who develop varices at sites of portosystemic venous collaterals has gastric varices due to hepatofugal flow into the gastric veins. Bleeding from gastric varices, though less common, has a higher mortality and morbidity compared to bleeding esophageal varices, which are easier to manage endoscopically. The efferent channel for gastric varices is mostly the gastrorenal shunt (GRS) which opens into the left renal vein. Balloon-occluded transvenous obliteration (BRTO) involves accessing the GRS with an aim to temporarily occlude its outflow using a balloon catheter and at the same time injecting sclerosant mixture within the varix so as to cause its thrombosis and thereby obliteration...
January 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28512755/evaluation-of-safety-of-concomitant-splenectomy-in-living-donor-liver-transplantation
#2
Amr Badawy, Yuhei Hamaguchi, Satoru Seo, Tochimi Kaido, Hideaki Okajima, Shinji Uemoto
In Asian countries, concomitant splenectomy in living donor liver transplantation (LDLT) is indicated to modulate the portal vein pressure in the small sized graft to protect against small for size syndrome. While concomitant splenectomy in deceased donor liver transplantation is almost contraindicated based on western reports of increased mortality and morbidity rate due to septic complications, there are few studies about that in LDLT. So, we retrospectively investigated the clinical outcome of adult LDLT at Kyoto University Hospital from July 2010 to July 2016...
May 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28511440/portal-venous-thrombosis-eosinophilic-vasculitis
#3
Vasanthi Natarajan, David Jose, Kevin John, Ashok Kumar Das
Portal Vein Thrombosis (PVT) is caused by various thrombophilic states. PVT secondary to underlying vasculitis especially Churg-Strauss disease is among the rarest presentation. Here, we report a case of peripheral eosinophilia, eosinophilic ascitis and venous thrombosis involving portal vein and superior mesenteric vein diagnosed as Churg-Strauss Syndrome (CSS). He was managed with steroids and anticoagulants. Following initiation of steroids, eosinophilia and eosinophilic ascitis improved.
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28507925/stratified-platelet-to-lymphocyte-ratio-a-novel-target-for-prognostic-prediction-of-hepatocellular-carcinoma-after-curative-liver-resection
#4
Gui-Qian Huang, Ji-Na Zheng, Tian-Tian Zou, Yi-Ran Chen, Ke-Qing Shi, Sven Van Poucke, Zhang Cheng, Lu-Yi Ruan, Ming-Hua Zheng
Background and Aims: Platelet-to-lymphocyte ratio (PLR) has been shown to predict prognosis of cancers. We aimed to evaluate the prognostic value of stratification of PLR in patients after curative liver resection (CLR) for hepatocellular carcinoma (HCC). Methods: A total of 1804 patients who underwent CLR for suspected HCC between January 2007 and January 2014 were screened for the study. All of the patients were categorized into equal tertiles according to the number of patients and the distribution of PLR...
March 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28506055/clinical-features-and-outcomes-of-patients-with-hepatocellular-carcinoma-complicated-with-bile-duct-invasion
#5
Jihyun An, Kwang Sun Lee, Kang Mo Kim, Do Hyun Park, Sang Soo Lee, Danbi Lee, Ju Hyun Shim, Young-Suk Lim, Han Chu Lee, Young-Hwa Chung, Yung Sang Lee
Background/Aims: Little is known about the treatment or outcomes of hepatocellular carcinoma (HCC) complicated with bile duct invasion. Methods: A total of 247 consecutive HCC patients with bile duct invasion at initial diagnosis were retrospectively included. Results: The majority of patients had Barcelona Clinic Liver Cancer (BCLC) stage C HCC (66.8%). Portal vein tumor thrombosis was present in 166 (67.2%) patients. Median survival was 4...
May 16, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28498107/ultrasound-assisted-thrombolysis-of-an-occluded-transjugular-portosystemic-shunt
#6
Nicholas Hilliard, Teik Choon See, Nadeem Shaida
Transjugular intrahepatic portosystemic shunt (TIPS) insertion is commonly performed for refractory ascites or variceal bleeding. However, TIPS dysfunction can be seen in both early and late settings, with shunt thrombosis a particular problem. Treatment of shunt dysfunction commonly involves angioplasty and re-lining, with or without embolectomy, mechanical thrombectomy, or thrombolysis. Ultrasound-assisted thrombolysis has been shown to be successful for treatment of pulmonary embolism, deep vein thrombosis, and peripheral arterial thromboembolism, but has not been described before for TIPS occlusion...
May 12, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28496539/efficacy-and-safety-of-direct-acting-oral-anticoagulants-use-in-acute-portal-vein-thrombosis-unrelated-to-cirrhosis
#7
Filipe Nery, Diana Valadares, Sara Morais, Manuel Teixeira Gomes, Andrea De Gottardi
In acute portal vein thrombosis (APVT) unrelated to cirrhosis, anticoagulant therapy is classically started with low molecular weight heparin or vitamin K antagonists. New direct-acting oral anticoagulants (DOACs) are used in the treatment of venous thrombosis outside the splanchnic vascular bed, but not in the latter. We report a young female with APVT occurring in a non-cirrhotic liver linked to heterozygosity of factor V-Leiden and prothrombin G20210A gene mutations. Rivaroxaban was started, with total recanalization of the left and partial recanalization of the right portal vein branches, without complications...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28495438/african-americans-have-a-lower-prevalence-of-portal-vein-thrombosis-at-the-time-of-liver-transplantation
#8
Dmitri Bezinover, Ethan Reeder, Faisal Aziz, Fuat Saner, Patrick McQuillan, Zakiyah Kadry, Thomas Riley, Dmitri Guvakov, Piotr K Janicki
BACKGROUND: Perioperative vascular thrombotic events in patients undergoing liver transplantation (LT) are associated with significant morbidity and mortality. METHODS: In this retrospective UNOS database analysis, we evaluated the prevalence of portal vein thrombosis (PVT) and factors contributing to PVT development in different ethnic groups. RESULTS: Of the 47 953 LT performed between 2002 and 2015, we identified 3642 cases of PVT. African Americans (AA) had a significantly lower prevalence of PVT compared to other ethnic groups (p = 0...
May 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28494528/a-comparative-study-of-sorafenib-and-metronomic-chemotherapy-for-barcelona-clinic-liver-cancer-stage-c-hepatocellular-carcinoma-with-poor-liver-function
#9
Hyun Yang, Hyun Young Woo, Soon Kyu Lee, Ji Won Han, Bohyun Jang, Hee Chul Nam, Hae Lim Lee, Sung Won Lee, Do Seon Song, Myeong Jun Song, Jung Suk Oh, Ho Jong Chun, Jeong Won Jang, Angelo Lozada, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon
Background/Aims: Metronomic chemotherapy (MET) is frequently administered in comparatively low doses as a continuous chemotherapeutic agent. The aim of this study was to evaluate the feasibility and overall survival (OS) of MET compared to sorafenib for advanced hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT). Methods: A total of 54 patients with advanced HCC and PVTT who had undergone MET were analyzed between 2005 and 2013. A total of 53 patients who had undergone sorafenib therapy were analyzed as the control group...
May 10, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28491882/portal-vein-thrombosis-in-the-setting-of-newly-diagnosed-cushing-s-syndrome
#10
Alexandria D McDow, Anju Gurung, Rama Poola, Carmel Fratianni, Marc Garfinkel, Michael G Jakoby
The hallmark manifestations of Cushing's syndrome (CS) are well known, but hypercoagulability is perhaps least recognized. Patients with CS are at increased risk of both spontaneous and postoperative thromboembolism, with the significant majority of events occurring in the lower extremity and pulmonary venous circulations. We present a case of portal vein thrombosis (PVT) occurring in the setting of newly diagnosed CS due to a left adrenal adenoma. Factor VIII activity was approximately 2.5-fold elevated, a known mechanism by which hypercortisolemia predisposes to venous thrombosis...
April 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28491181/tips-performed-in-a-patient-with-complete-portal-vein-thrombosis
#11
Ashwani Kumar Sharma, David Charles Kaufman
Portal vein thrombosis is common in cirrhotic patients and results in increased morbidity and mortality. Transjugular intrahepatic portosystemic shunt (TIPS) creation is a well-established therapy for refractory variceal bleeding and refractory ascites in patients who do not tolerate repeated large volume paracentesis. Experience and technical improvements have led to improved TIPS outcomes that have encouraged an expanded application. Complete portal vein thrombosis has come a long way from being a contraindication to an indication for TIPS procedure...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28489645/portal-vein-thrombosis-in-cirrhosis
#12
Michael Loudin, Joseph Ahn
Portal vein thrombosis (PVT) in the cirrhotic population is a challenging clinical phenomenon requiring a nuanced management approach. Uncertainty exists regarding the clinical significance of PVT in the cirrhotic population because the data for PVT are based mainly on retrospective, small cohort studies. Therefore, strong recommendations regarding the optimal timing, modality, and duration of therapy for PVT in the cirrhotic population cannot be made. However, this review aims to summarize the current literature and provide stepwise guidance in diagnosing and managing PVT in patients with cirrhosis...
May 9, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28489255/increased-risk-of-portal-vein-thrombosis-in-patients-with-autoimmune-hepatitis-on-the-liver-transplantation-waiting-list
#13
Pablo Ruiz, Lydia Sastre, Gonzalo Crespo, Annabel Blasi, Jordi Colmenero, Juan Carlos García-Valdecasas, Miquel Navasa
Liver transplantation (LT) is indicated in autoimmune hepatitis (AIH) for both acute presentation with liver failure and end-stage chronic liver disease. Few studies have suggested an association between AIH and coagulation disorders and a higher incidence of portal vein thrombosis (PVT) in patients with AIH listed for LT. The aim of this study was to determine the incidence of thrombotic complications, particularly PVT, in a cohort of 37 patients undergoing LT because of AIH. PVT was present before transplantation in 30% (n=11) of these patients compared to 11% in the whole population transplanted in our centre (p=0...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28486226/role-of-albumin-in-growth-inhibition-in-hepatocellular-carcinoma
#14
Ezgi Bağırsakçı, Eren Şahin, Neşe Atabey, Esra Erdal, Vito Guerra, Brian I Carr
OBJECTIVE: Levels of serum albumin have recently emerged, together with C-reactive protein, as an important prognostic indicator for hepatocellular carcinoma (HCC). It has recently been reported that larger HCCs are associated with lower albumin levels. However, the albumin-mediated growth decrease has yet to be determined. METHODS: We examined a large HCC cohort and then by direct exposure of HCC cells in vitro, the relationship of albumin levels to HCC growth...
May 10, 2017: Oncology
https://www.readbyqxmd.com/read/28485081/risk-of-different-precipitating-events-for-progressing-to-acute-on-chronic-liver-failure-in-hbv-related-cirrhotic-patients
#15
Shan Yin, Shi Jin Wang, Wen Yi Gu, Yan Zhang, Liu Ying Chen, Hai Li
OBJECTIVE: Acute-on-chronic liver failure (ACLF) is a distinct syndrome that develops in cirrhotic patients with acute decompensation (AD). This study focused on the precipitating events (PEs) of HBV related cirrhotic ACLF diagnosed by CLIF-OF score. METHODS: 890 hospitalized HBV related cirrhotic patients with AD were retrospectively included from Renji hospital, Shanghai, China. Precipitating events, CLIF-OF score, and short term prognosis were evaluated. RESULTS: For enrolled 890 patients, there were 300 (33...
May 9, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28483616/endovascular-treatment-of-an-unusual-membranous-obstruction-of-the-inferior-vena-cava-in-budd-chiari-syndrome-complicated-by-mural-portal-vein-thrombosis
#16
Wen-Guang Zhang, Dong-Mei Liu, Xin-Wei Han, Jian-Zhuang Ren, Peng-Li Zhou, Zhong-Gao Wang
No abstract text is available yet for this article.
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28481004/tips-and-pitfalls-in-direct-ligation-of-large-spontaneous-splenorenal-shunt-during-liver-transplantation
#17
Hyeyoung Kim, Kyung Chul Yoon, Kwang-Woong Lee, Nam-Joon Yi, Hae Won Lee, YoungRok Choi, Dongkyu Oh, Hyo-Sin Kim, Suk Kyun Hong, Sung Woo Ahn, Kyung-Suk Suh
Patients with large spontaneous splenorenal shunt (SRS) prove challenging during liver transplantation (LT), irrespective of organizing portal vein (PV) thrombosis. Here, we detail the clinical outcomes of 26 patients who underwent direct ligation of large SRS during LT. Direct ligation of large SRS was applied in poor portal flow during LT. We performed temporary test clamping of the SRS before direct ligation and applied PV pressure monitoring in patients who showed signs of portal hypertension, such as bowel edema...
May 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28480062/locoregional-and-systemic-therapy-for-hepatocellular-carcinoma
#18
REVIEW
Olumide B Gbolahan, Michael A Schacht, Eric W Beckley, Thomas P LaRoche, Bert H O'Neil, Maximilian Pyko
The management of hepatocellular carcinoma (HCC) remains challenging due to late presentation and the presence of accompanying liver dysfunction. As such, most patients are not eligible for curative resection and liver transplant. Management in this scenario depends on a number of factors including hepatic function, tumor burden, patency of hepatic vasculature and patients' functional status. Based on these, patients can be offered catheter based intra-arterial therapy for intermediate stage disease and in more advanced disease, sorafenib...
April 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28479379/effects-of-anticoagulants-in-patients-with-cirrhosis-and-portal-vein-thrombosis-a-systematic-review-and-meta-analysis
#19
Lorenzo Loffredo, Daniele Pastori, Alessio Farcomeni, Francesco Violi
BACKGROUND & AIMS: Liver cirrhosis is complicated by bleeding from portal hypertension but also by portal vein thrombosis (PVT). PVT occurs in about 20%-50% of patients with cirrhosis, and is a warning sign for poor outcome. It is a challenge to treat patients with cirrhosis using anticoagulants, because of the perception that the coexistent coagulopathy could promote bleeding. We performed a systematic review and meta-analysis to determine the effects of anticoagulant therapy in patients with cirrhosis and PVT...
May 4, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28473933/melioidosis-with-portal-vein-thrombosis
#20
Thanyaporn Direksunthorn
Melioidosis, caused by Burkholderia pseudomallei, is a common infectious disease in tropical regions. The author reports a case of melioidosis with a rare manifestation of portal vein thrombosis and cavernous transformation of the portal vein. Melioidosis should be considered a differential diagnosis in patients with underlying risk factors who present with multiple liver abscesses; moreover, portal vein thrombosis can be a potential complication. Computed tomography is the modality of choice to demonstrate venous thrombosis in various organs...
2017: Case Reports in Infectious Diseases
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