Catholic University of Rome, Department of Internal Medicine, Largo A. Gemelli 8, 00168 Rome, Italy.
Expert Opin Pharmacother. 2010 Jun;11(9):1479-87. doi: 10.1517/14656561003749264.
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.
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.
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.
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.
门静脉血栓形成（PVT）是肝硬化的主要并发症之一。估计代偿性疾病患者的患病率<1%；在肝移植候选人中，这一比例增至 8-25%。许多决定因素可能影响 PVT 的临床表现及其结局。
我们报告了关于 PVT 管理的现有知识，并分析了不同的治疗方法，特别关注抗凝剂的使用及其在肝硬化复杂临床环境中的影响。我们还描述了可能存在的预防性策略，因为基于临床、生化或影像学参数的早期预防性管理可能会降低 PVT 的发生率和并发症，改善患者的结局。
准确诊断 PVT 的重要性及其对 PVT 管理的影响；描述不同可用的治疗工具，以及它们在不同类型患者中的疗效和可能的风险；为 PVT 患者选择正确个体化治疗的主要因素。
临床医生面临的挑战是早期识别 PVT，以预防可怕的并发症，如静脉曲张出血或肠系膜梗死，并提供最佳的治疗管理。
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