Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, China.
Division of Gastroenterology, Vancouver General Hospital, Vancouver, BC, Canada.
BMC Med. 2018 Jun 5;16(1):83. doi: 10.1186/s12916-018-1069-8.
In real-world clinical practice, the acceptance of anticoagulation therapy in the management of portal vein thrombosis (PVT) in patients with cirrhosis is limited by the fear of an increased bleeding risk. Additionally, accumulating evidence indicates that spontaneous recanalization of PVT may occur in the absence of antithrombotic treatment. Therefore, risk stratification based on outcomes in such patients is crucial for determining a therapeutic strategy. In this paper, we draw attention to the distinct clinical entity, "transient PVT" by introducing two cases with PVT that spontaneously recanalized in the absence of antithrombotic treatment. We reviewed the available data regarding the probability of and predictors for spontaneous recanalization of PVT. Available data suggest singling out transient thrombosis in the natural history of PVT in patients with cirrhosis because of its prognostic and management implications.
在现实临床实践中，由于担心出血风险增加，抗凝治疗在肝硬化患者门静脉血栓（PVT）管理中的接受程度有限。此外，越来越多的证据表明，在没有抗血栓治疗的情况下，PVT 可能会自发再通。因此，基于此类患者结局的风险分层对于确定治疗策略至关重要。在本文中，我们通过介绍两例 PVT 患者在没有抗血栓治疗的情况下自发再通的病例，提请注意“一过性 PVT”这一独特的临床实体。我们回顾了关于 PVT 自发性再通的概率和预测因素的现有数据。现有数据表明，由于其预后和管理意义，在肝硬化患者 PVT 的自然病程中，应将一过性血栓单独挑出。
