Background and Aims: Portal vein thrombosis is common consequence of cirrhosis and portal hypertension. Recent studies have showed that prophylactic anticoagulation prevented portal vein thrombosis (PVT) and decreased episodes of decompensation of cirrhosis. We aim to assess effect of anticoagulation for portal vein recanalization in non-tumoral portal vein thrombosis with cirrhosis and its effect on prognosis.
Methods: 45 patients of cirrhosis with nontumoral PVT were included in study. PVT was diagnosed by PV Doppler study. Decision to start anticoagulation was taken at the discretion of the clinician managing the patient. The effect of anticoagulation on PVT recanalization was analyzed.
Results: The mean age was 52.8± 9.26 years and 26 (57.8%) were males. Severity of cirrhosis was assessed by Child–Pugh (CP) score & MELD score. Anticoagulation (LMWH–9, heparin–16) was administered in 30/45(66.7%) patients. 24/30 (80%) attained recanalization (Total–16, partial – 8) of the portal vein. By Cox regression analysis, factors associated with mortality at the end of follow-up were: Age (HR 0.021, 95% C.I. 0.943–1.106, p= 0.608), CP score (HR-2.305, 95% C.I. 0.007–1.487, p= 0.095), MELD score (HR 0.582, 95% C.I. 0.352–9.102, p= 0.483), bilirubin (HR -0.362, C.I. 0.175-2.777, p=0.608). Portal vein recanalization was more frequent in patients on anticoagulation than no anticoagulation (80% vs. 13.3%) (p= 0.005).
Conclusions: Anticoagulation in patients with cirrhosis and PVT appears to be safe and associated with higher portal vein recanalization rates and significantly lower mortality.
Impact Factor
2022: 6.012
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