Barnum Kevin J, Patell Rushad, Berry Jonathan, Bauer Kenneth A
Division of Hematology and Hematologic Malignancies, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Division of Hematology and Hematologic Malignancies, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: https://twitter.com/rushadpatell.
J Thromb Haemost. 2025 Feb;23(2):404-416. doi: 10.1016/j.jtha.2024.10.012. Epub 2024 Oct 21.
Splanchnic vein thrombosis (SpVT) is an uncommon site of venous thrombosis that is associated with complications including portal hypertension and hepatic dysfunction. The evaluation and management of this patient population has evolved in recent years, but there are limited data from clinical trials to guide management. Given the various acquired and biologic risk factors leading to the development of SpVT and the potential complications that can arise from it, input from a multidisciplinary team can be valuable in managing such patients, including thrombosis specialists or hematologists, gastroenterologists or hepatologists, interventional radiologists, and surgeons. In this article, we present 4 cases that highlight important issues and considerations in the evaluation of SpVT, including initial diagnostic approach in a patient with a new diagnosis of SpVT, considerations for anticoagulant therapy, management of SpVT in patients with myeloproliferative neoplasms, and the role of interventional vascular procedures in the management of SpVT. By reviewing the current literature, we address clinically relevant questions that are posed to clinicians managing patients with SpVT; we also point out gaps in our current knowledge that merit future investigation.
内脏静脉血栓形成（SpVT）是静脉血栓形成的一个罕见部位，与包括门静脉高压和肝功能障碍在内的并发症相关。近年来，对这一患者群体的评估和管理有所发展，但来自临床试验的数据有限，难以指导管理。鉴于导致SpVT发生的各种后天和生物学危险因素以及由此可能引发的潜在并发症，多学科团队的意见对于管理此类患者可能很有价值，这些团队包括血栓形成专家或血液科医生、胃肠病学家或肝病学家、介入放射科医生和外科医生。在本文中，我们介绍4例病例，突出了SpVT评估中的重要问题和注意事项，包括SpVT新诊断患者的初始诊断方法、抗凝治疗的考虑因素、骨髓增殖性肿瘤患者SpVT的管理以及介入血管手术在SpVT管理中的作用。通过回顾当前文献，我们解答了临床医生在管理SpVT患者时遇到的临床相关问题；我们还指出了当前知识中的空白，值得未来进行研究。
