Management of portal vein thrombosis in liver cirrhosis

Nature Reviews Gastroenterology and Hepatology

Volumn 11, Issue 7, 2014, Pages 435-446

  Qi, Xingshun ^a   Han, Guohong ^a   Fan, Daiming ^a  

^a FOURTH MILITARY MEDICAL UNIVERSITY   (China)

Author keywords

[No Author keywords available]

Indexed keywords

ALTEPLASE; ANTICOAGULANT AGENT; ANTIVITAMIN K; ENOXAPARIN; HEPARIN; LOW MOLECULAR WEIGHT HEPARIN; WARFARIN;

BLEEDING; BLOOD CLOT LYSIS; BLOOD VESSEL DIAMETER; CONTINUOUS INFUSION; DRUG CONTRAINDICATION; DRUG EFFICACY; DRUG SAFETY; GASTROINTESTINAL HEMORRHAGE; HUMAN; LIVER CIRRHOSIS; LIVER FIBROSIS; LIVER FUNCTION; MECHANICAL THROMBECTOMY; OUTCOME ASSESSMENT; OVERALL SURVIVAL; PATIENT SELECTION; PERCUTANEOUS PORTAL VEIN RECANALIZATION; PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY; PORTAL HYPERTENSION; PORTAL VEIN THROMBOSIS; PRIMARY PREVENTION; PRIORITY JOURNAL; RECANALIZATION; REVIEW; RISK ASSESSMENT; THROMBOCYTOPENIA; THROMBOSIS PREVENTION; TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT; VENOUS THROMBOEMBOLISM;

ALGORITHMS; ANTICOAGULANTS; HUMANS; LIVER CIRRHOSIS; PORTAL VEIN; PORTASYSTEMIC SHUNT, SURGICAL; THROMBOLYTIC THERAPY; THROMBOSIS;

EID: 84903817337     PISSN: 17595045     EISSN: 17595053     Source Type: Journal    
DOI: 10.1038/nrgastro.2014.36     Document Type: Review

References (144)

1. Cohen, J., Edelman, R. R. & Chopra, S. Portal vein thrombosis: a review. Am. J. Med. 92, 173-182 (1992).
2. Parikh, S., Shah, R. & Kapoor, P. Portal vein thrombosis. Am. J. Med. 123, 111-119 (2010).
3. Valla, D. C. & Condat, B. Portal vein thrombosis in adults: pathophysiology, pathogenesis and management. J. Hepatol. 32, 865-871 (2000). (Pubitemid 30262750)
4. Qi, X., Han, G., Bai, M. & Fan, D. Stage of portal vein thrombosis. J. Hepatol. 54, 1080-1082 (2011).
5. Qi, X., Han, G., Wang, J., Wu, K. & Fan, D. Degree of portal vein thrombosis. Hepatology 51, 1089-1090 (2010).
6. Yerdel, M. A. et al. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome. Transplantation 69, 1873-1881 (2000). (Pubitemid 30340348)
7. Nonami, T., Yokoyama, I., Iwatsuki, S. & Starzl, T. E. The incidence of portal vein thrombosis at liver transplantation. Hepatology 16, 1195-1198 (1992).
8. Jamieson, N. V. Changing perspectives in portal vein thrombosis and liver transplantation. Transplantation 69, 1772-1774 (2000). (Pubitemid 30340331)
9. Bauer, J. et al. The role of TIPS for portal vein patency in liver transplant patients with portal vein thrombosis. Liver Transpl. 12, 1544-1551 (2006). (Pubitemid 44594288)
10. Fimognari, F. L. & Violi, F. Portal vein thrombosis in liver cirrhosis. Intern. Emerg. Med. 3, 213-218 (2008).
11. Tsochatzis, E. A., Senzolo, M., Germani, G., Gatt, A. & Burroughs, A. K. Systematic review: portal vein thrombosis in cirrhosis. Aliment. Pharmacol. Ther. 31, 366-374 (2010).
12. Amitrano, L. et al. Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis. J. Hepatol. 40, 736-741 (2004). (Pubitemid 38507352)
13. Francoz, C. et al. Splanchnic vein thrombosis in candidates for liver transplantation: usefulness of screening and anticoagulation. Gut 54, 691-697 (2005). (Pubitemid 40559257)
14. Zocco, M. A. et al. Thrombotic risk factors in patients with liver cirrhosis: correlation with MELD scoring system and portal vein thrombosis development. J. Hepatol 51, 682-689 (2009).
15. Maruyama, H., Okugawa, H., Takahashi, M. & Yokosuka, O. De novo portal vein thrombosis in virus-related cirrhosis: predictive factors and long-term outcomes. Am. J. Gastroenterol. 108, 568-574 (2013).
16. Senzolo, M. & Garcia-Pagan, J. C. Incidence and natural course of portal vein thrombosis in cirrhosis. Am. J. Gastroenterol. 108, 1807-1808 (2013).
17. Trinchet, J. C. et al. Ultrasonographic surveillance of hepatocellular carcinoma in cirrhosis: a randomized trial comparing 3-and 6-month periodicities. Hepatology 54, 1987-1997 (2011).
18. Nery, F. G. et al. Portal vein thrombosis (PVT) in compensated cirrhosis: A prospective cohort study on 898 patients. Hepatology 58, 271A (2013).
19. US National Library of Medicine. ClinicalTrials.gov [online], http://clinicaltrials.gov/ct2/results?term=NCT01470547.
20. Pellicelli, A. M. et al. Clinical and genetic factors associated to development of portal vein thrombosis in cirrhotic patients without hepatocellular carcinoma. J. Hepatol. 54, S77 (2011).
21. Lutz, H. H., Gassler, N., Tischendorf, F. W., Trautwein, C. & Tischendorf, J. J. Doppler ultrasound of hepatic blood flow for noninvasive evaluation of liver fibrosis compared with liver biopsy and transient elastography. Dig. Dis. Sci. 57, 2222-2230 (2012).
22. Amitrano, L. et al. Inherited coagulation disorders in cirrhotic patients with portal vein thrombosis. Hepatology 31, 345-348 (2000). (Pubitemid 30078598)
23. Erkan, O. et al. Thrombophilic gene mutations in cirrhotic patients with portal vein thrombosis. Eur. J. Gastroenterol. Hepatol. 17, 339-343 (2005). (Pubitemid 40411221)
24. Mangia, A. et al. Causes of portal venous thrombosis in cirrhotic patients: the role of genetic and acquired factors. Eur. J. Gastroenterol. Hepatol. 17, 745-751 (2005). (Pubitemid 40896421)
25. Gabr, M. A., Bessa, S. S. & El-Zamarani, E. A. Portal vein thrombosis in Egyptian patients with liver cirrhosis: Role of methylenetetrahydrofolate reductase C677T gene mutation. Hepatol. Res. 40, 486-493 (2010).
26. Violi, F. et al. Relation between lupus anticoagulant and splanchnic venous thrombosis in cirrhosis of the liver. BMJ 309, 239-240 (1994). (Pubitemid 24252660)
27. Rossetto, V. et al. Does decreased fibrinolysis have a role to play in the development of non-neoplastic portal vein thrombosis in patients with hepatic cirrhosis? Intern. Emerg. Med. http://dx.doi.org/10.1007/s11739-013- 0929-7.
28. Dentali, F., Galli, M., Gianni, M. & Ageno, W. Inherited thrombophilic abnormalities and risk of portal vein thrombosis. A meta-analysis. Thromb. Haemost. 99, 675-682 (2008). (Pubitemid 351694223)
29. Zhang, D., Hao, J. & Yang, N. Protein C and D-dimer are related to portal vein thrombosis in patients with liver cirrhosis. J. Gastroenterol. Hepatol. 25, 116-121 (2010).
30. Zhang, D. L., Hao, J. Y. & Yang, N. Value of D-dimer and protein S for diagnosis of portal vein thrombosis in patients with liver cirrhosis. J. Int. Med. Res. 41, 664-672 (2013).
31. Qi, X., Chen, H. & Han, G. Effect of antithrombin, protein C and protein S on portal vein thrombosis in liver cirrhosis: a meta-analysis. Am. J. Med. Sci 346, 38-44 (2013).
32. Chen, H. et al. Coagulation imbalance may not contribute to the development of portal vein thrombosis in patients with cirrhosis. Thromb. Res. 131, 173-177 (2013).
33. Attili, A. F. et al. Portal vein thrombosis is a risk factor for death and complications in liver cirrhosis. Dig. Liver Dis. 44 (Suppl 2), S107 (2012).
34. John, B. V. et al. Impact of untreated portal vein thrombosis on pre and post liver transplant outcomes in cirrhosis. Ann. Hepatol. 12, 952-958 (2013).
35. Englesbe, M. J. et al. Portal vein thrombosis and survival in patients with cirrhosis. Liver Transpl. 16, 83-90 (2010).
36. Englesbe, M. J., Schaubel, D. E., Cai, S., Guidinger, M. K. & Merion, R. M. Portal vein thrombosis and liver transplant survival benefit. Liver Transpl. 16, 999-1005 (2010).
37. Cho, J. Y. et al. Thrombosis confined to the portal vein is not a contraindication for living donor liver transplantation. World J. Surg. 32, 1731-1737 (2008).
38. Suarez Artacho, G. et al. Outcomes of liver transplantation in candidates with portal vein thrombosis. Transplant. Proc. 42, 3156-3158 (2010).
39. Doenecke, A. et al. Pre-existent portal vein thrombosis in liver transplantation: influence of pre-operative disease severity. Clin. Transplant. 24, 48-55 (2010).
40. Pan, C. et al. Single-center experience of 253 portal vein thrombosis patients undergoing liver transplantation in China. Transplant. Proc. 41, 3761-3765 (2009).
41. Tao, Y. F. et al. Liver transplant recipients with portal vein thrombosis: a single center retrospective study. Hepatobiliary Pancreat. Dis. Int. 8, 34-39 (2009).
42. Llado, L. et al. Management of portal vein thrombosis in liver transplantation: influence on morbidity and mortality. Clin. Transplant. 21, 716-721 (2007). (Pubitemid 350056138)
43. Lendoire, J. et al. Liver transplantation in adult patients with portal vein thrombosis: risk factors, management and outcome. HPB (Oxford) 9, 352-356 (2007). (Pubitemid 47604635)
44. Rodriguez-Castro, K. I. et al. Management of nonneoplastic portal vein thrombosis in the setting of liver transplantation: a systematic review. Transplantation 94, 1145-1153 (2012).
45. Qi, X. et al. Occlusive portal vein thrombosis as a new marker of decompensated cirrhosis. Med. Hypotheses 76, 522-526 (2011).
46. Hibi, T. et al. When and why portal vein thrombosis matters in liver transplantation: a critical audit of 174 cases. Ann. Surg. http://dx.doi.org/10. 1097/SLA.0000000000000252.
47. D'Amico, G. & De Franchis, R. Upper digestive bleeding in cirrhosis. Post-therapeutic outcome and prognostic indicators. Hepatology 38, 599-612 (2003). (Pubitemid 37052147)
48. Amitrano, L. et al. The effectiveness of current acute variceal bleed treatments in unselected cirrhotic patients: refining short-term prognosis and risk factors. Am. J. Gastroenterol 107, 1872-1878 (2012).
49. Xu, L., Ji, F., Xu, Q. W. & Zhang, M. Q. Risk factors for predicting early variceal rebleeding after endoscopic variceal ligation. World J. Gastroenterol. 17, 3347-3352 (2011).
50. Chen, P. H. et al. Delayed endoscopy increases re-bleeding and mortality in patients with hematemesis and active esophageal variceal bleeding: a cohort study. J. Hepatol. 57, 1207-1213 (2012).
51. Lee, S. W., Lee, T. Y. & Chang, C. S. Independent factors associated with recurrent bleeding in cirrhotic patients with esophageal variceal hemorrhage. Dig. Dis. Sci. 54, 1128-1134 (2009).
52. Amitrano, L. et al. Splanchnic vein thrombosis and variceal rebleeding in patients with cirrhosis. Eur. J. Gastroenterol. Hepatol. 24, 1381-1385 (2012).
53. Hung., H. H. et al. Efficacy of non-selective beta-blockers as adjunct to endoscopic prophylactic treatment for gastric variceal bleeding: a randomized controlled trial. J. Hepatol. 56, 1025-1032 (2012).
54. Wu, C. Y., Yeh, H. Z. & Chen, G. H. Pharmacologic efficacy in gastric variceal rebleeding and survival: including multivariate analysis. J. Clin. Gastroenterol. 35, 127-132 (2002).
55. Lee, S. W. et al. Independent factors associated with early outcome in Chinese cirrhotic patients after cessation of initial esophageal variceal hemorrhage. J. Clin. Gastroenterol. 44, e123-e127 (2010).
56. Augustin, S. et al. Predicting early mortality after acute variceal hemorrhage based on classification and regression tree analysis. Clin. Gastroenterol. Hepatol. 7, 1347-1354 (2009).
57. DeLeve, L. D., Valla, D. C. & Garcia-Tsao, G. Vascular disorders of the liver. Hepatology 49, 1729-1764 (2009).
58. Garcia-Tsao, G. & Bosch, J. Management of varices and variceal hemorrhage in cirrhosis. N. Engl. J. Med. 362, 823-832 (2010).
59. Sogaard, K. K. et al. Risk of venous thromboembolism in patients with liver disease: a nationwide population-based case-control study. Am. J. Gastroenterol. 104, 96-101 (2009).
60. Northup, P. G. et al. Coagulopathy does not fully protect hospitalized cirrhosis patients from peripheral venous thromboembolism. Am. J. Gastroenterol. 101, 1524-1528 (2006). (Pubitemid 43980626)
61. Wu, H. & Nguyen, G. C. Liver cirrhosis is associated with venous thromboembolism among hospitalized patients in a nationwide US study. Clin. Gastroenterol. Hepatol. 8, 800-805 (2010).
62. Gulley, D., Teal, E., Suvannasankha, A., Chalasani, N. & Liangpunsakul, S. Deep vein thrombosis and pulmonary embolism in cirrhosis patients. Dig. Dis. Sci. 53, 3012-3017 (2008).
63. Dabbagh, O., Oza, A., Prakash, S., Sunna, R. & Saettele, T. M. Coagulopathy does not protect against venous thromboembolism in hospitalized patients with chronic liver disease. Chest 137, 1145-1149 (2010).
64. Tripodi, A. et al. An imbalance of pro- vs anti-coagulation factors in plasma from patients with cirrhosis. Gastroenterology 137, 2105-2111 (2009).
65. Tripodi, A. & Mannucci, P. M. The coagulopathy of chronic liver disease. N. Engl. J. Med. 365, 147-156 (2011).
66. Ali, M., Ananthakrishnan, A. N., McGinley, E. L. & Saeian, K. Deep vein thrombosis and pulmonary embolism in hospitalized patients with cirrhosis: a nationwide analysis. Dig. Dis. Sci. 56, 2152-2159 (2011).
67. Lesmana, C. R., Inggriani, S., Cahyadinata, L. & Lesmana, L. A. Deep vein thrombosis in patients with advanced liver cirrhosis: a rare condition? Hepatol. Int. 4, 433-438 (2010).
68. Intagliata, N., Henry, Z., Shah, N. L., Caldwell, S. H. & Northup, P. G. Prophylactic anticoagulation for deep venous thrombosis in hospitalized cirrhosis patients is safe and does not lead to increased bleeding events. Hepatology 54, 1253A (2011).
69. Gomez Cuervo, C., Bisbal Pardo, O. & Perez-Jacoiste Asin, M. A. Efficacy and safety of the use of heparin as thromboprophylaxis in patients with liver cirrhosis: a systematic review and meta-analysis. Thromb. Res. 132, 414-419 (2013).
70. Villa, E. et al. Enoxaparin prevents portal vein thrombosis and liver decompensation in patients with advanced cirrhosis. Gastroenterology 143, 1253-1260.e1-e4 (2012).
71. Huang, J. S. et al. Indigenous and imported low molecular weight heparin in the treatment of chronic hepatitis B and cirrhosis with hepatitis B virus: a prospective randomized controlled clinical study [Chinese]. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 19, 408-411 (2007).
72. Lee, H. M., Amin, M., Kaplan, M. M. & Herlihy, E. F. Reversible hepatic decompensation in primary biliary cirrhosis due to hypercoagulability. Ann. Intern. Med. 147, 675 (2007). (Pubitemid 351664496)
73. Calvaruso, V. et al. Coagulation and fibrosis in chronic liver disease. Gut 57, 1722-1727 (2008).
74. Assy, N. et al. Association between thrombotic risk factors and extent of fibrosis in patients with non-alcoholic fatty liver diseases. World J. Gastroenterol. 11, 5834-5839 (2005). (Pubitemid 41662835)
75. Papatheodoridis, G. V. et al. Thrombotic risk factors and extent of liver fibrosis in chronic viral hepatitis. Gut 52, 404-409 (2003). (Pubitemid 36250062)
76. Papatheodoridis, G. V. et al. Thrombotic risk factors and liver histologic lesions in non-alcoholic fatty liver disease. J. Hepatol. 51, 931-938 (2009).
77. Wanless, I. R. et al. Hepatic and portal vein thrombosis in cirrhosis: possible role in development of parenchymal extinction and portal hypertension. Hepatology 21, 1238-1247 (1995).
78. International Standard Randomized Controlled Trial Number Register. Current Controlled Trials [online], http://www.controlled-trials.com/ ISRCTN12504151.
79. Fontana, R. J. Prophylactic anticoagulation in cirrhotics: a paradox for prime time? Gastroenterology 143, 1138-1141 (2012).
80. Seijo, S. & Garcia-Pagan, J. C. Anticoagulation in cirrhosis: ready...set...wait! Hepatology 58, 1175-1176 (2013).
81. Zecchini, R. et al. Anticoagulant therapy is safe and effective in preventing portal vein thrombosis (PVT) in advanced cirrhotic patients: a prospective randomized controlled study. J. Hepatol. 52, S460 (2010).
82. Pocock, S. J. When to stop a clinical trial. BMJ 305, 235-240 (1992).
83. McPherson, K. Statistics: the problem of examining accumulating data more than once. N. Engl. J. Med. 290, 501-502 (1974).
84. Villa, E. et al. Enoxaparin prevents portal vein thrombosis (PVT) and decompensation in advanced cirrhotic patients: Final report of a prospective randomized controlled study. Hepatology 54, 418A (2011).
85. Rudler, M. & Thabut, D. Prophylactic enoxaparin in decompensated cirrhosis: a prevention of portal hypertension-related complications? Clin. Res. Hepatol. Gastroenterol. 37, 115-116 (2013).
86. Luca, A. et al. Natural course of extrahepatic nonmalignant partial portal vein thrombosis in patients with cirrhosis. Radiology 265, 124-132 (2012).
87. De Santis, A. et al. Portal vein thrombosis (PVT) in cirrhotic patients: prevalence and associated factors. Dig. Liver Dis. 33, (Suppl. 1), A61 (2001).
88. Qi, X., Wang, J., Chen, H., Han, G. & Fan, D. Nonmalignant partial portal vein thrombosis in liver cirrhosis: to treat or not to treat? Radiology 266, 994-995 (2013).
89. Congly, S. E. & Lee, S. S. Portal vein thrombosis: should anticoagulation be used? Curr. Gastroenterol. Rep. 15, 306 (2013).
90. Qi, X. & Han, G. Transjugular intrahepatic portosystemic shunt in the treatment of portal vein thrombosis: a critical review of literature. Hepatol. Int. 6, 576-590 (2012).
91. Ponziani, F. R., Zocco, M. A., Tortora, A., Gasbarrini, G. & Gasbarrini, A. Anticoagulants in cirrhotic patients: controversies and certainties in PVT management. Cardiovasc. Hematol. Agents Med. Chem. 9, 183-189 (2011).
92. Hirsh, J. & Fuster, V. Guide to anticoagulant therapy. Part 2: Oral anticoagulants. American Heart Association. Circulation 89, 1469-1480 (1994). (Pubitemid 24076569)
93. Hirsh, J. & Fuster, V. Guide to anticoagulant therapy. Part 1: Heparin. American Heart Association. Circulation 89, 1449-1468 (1994). (Pubitemid 24076568)
94. Campbell, S. & Lachlan, N. J. Anticoagulation for cirrhotic portal vein thrombosis: bold, brave, and possibly beneficial. Clin. Gastroenterol. Hepatol. 10, 784-785 (2012).
95. Amitrano, L. et al. Safety and efficacy of anticoagulation therapy with low molecular weight heparin for portal vein thrombosis in patients with liver cirrhosis. J. Clin. Gastroenterol. 44, 448-451 (2010).
96. Senzolo, M. et al. Prospective evaluation of anticoagulation and transjugular intrahepatic portosystemic shunt for the management of portal vein thrombosis in cirrhosis. Liver Int. 32, 919-927 (2012).
97. Delgado, M. G. et al. Efficacy and safety of anticoagulation on patients with cirrhosis and portal vein thrombosis. Clin. Gastroenterol. Hepatol. 10, 776-783 (2012).
98. Maruyama, H., Takahashi, M., Shimada, T. & Yokosuka, O. Emergency anticoagulation treatment for cirrhosis patients with portal vein thrombosis and acute variceal bleeding. Scand. J. Gastroenterol. 47, 686-691 (2012).
99. Werner, K. T. et al. Portal vein thrombosis in patients with end stage liver disease awaiting liver transplantation: outcome of anticoagulation. Dig. Dis. Sci. 58, 1776-1780 (2013).
100. Francoz, C. et al. Screening for portal vein thrombosis in candidates for liver transplantation and anticoagulation until transplantation: Results of a prospective assessment. Liver Transpl. 14, S245 (2008).
101. Senzolo, M., Ferronato, C., Burra, P. & Sartori, M. T. Anticoagulation for portal vein thrombosis in cirrhotic patients should be always considered. Intern. Emerg. Med. 4, 161-162 (2009).
102. Romero-Gomez, M., Gutierrez-Tous, R. & Delgado-Mije, D. Anticoagulation therapy for recent portal vein thrombosis in a patient with liver cirrhosis suffering from variceal rebleeding. Gastroenterology 122, 2095 (2002). (Pubitemid 34651455)
103. Bento, L. et al. Antihrombotic therapy in non-neoplastic chronic portal venous thrombosis in cirrhosis: Recanalization and liver function evaluation. Blood 118, 3358A (2011).
104. Takatori, H. et al. Danaparoid sodium monotherapy for portal vein thrombosis in cirrhotic patients is as effective as combination therapy with antithrombin III. Hepatology 58, 894A (2013).
105. Copaci, I., Ismail, G., Micu, L., Ioanitescu, S. & Chiriac, G. Anticoagulant therapy with sulodexidum for portal vein thrombosis in patients with liver cirrhosis. Hepatology 58, 867A-868A (2013).
106. Christol, C. et al. Bleeding risk of endoscopic variceal ligation (EVL) in patients with portal vein thrombosis (PVT) and anticoagulation: an analysis of 1235 procedures J. Hepatol. 56, S261 (2012).
107. US National Library of Medicine. ClinicalTrials.gov [online], http://clinicaltrials.gov/ct2/show/NCT01631877?term=NCT01631877&rank=1.
108. Giannini, E. G. & Savarino, V. Which anticoagulant drug should be used to treat portal vein thrombosis in patients with chronic liver disease? Clin. Gastroenterol. Hepatol. 11, 103 (2013).
109. Hull, R. et al. Different intensities of oral anticoagulant therapy in the treatment of proximal-vein thrombosis. N. Engl. J. Med. 307, 1676-1681 (1982). (Pubitemid 13206049)
110. Hirsh, J., Fuster, V., Ansell, J. & Halperin, J. L. American Heart Association/American College of Cardiology Foundation guide to warfarin therapy. Circulation 107, 1692-1711 (2003). (Pubitemid 36397341)
111. Veeger, N. J., Piersma-Wichers, M., Tijssen, J. G., Hillege, H. L. & van der Meer, J. Individual time within target range in patients treated with vitamin K antagonists: main determinant of quality of anticoagulation and predictor of clinical outcome. A retrospective study of 2300 consecutive patients with venous thromboembolism. Br. J. Haematol. 128, 513-519 (2005). (Pubitemid 40283170)
112. Bauersachs, R. et al. Oral rivaroxaban for symptomatic venous thromboembolism. N. Engl. J. Med. 363, 2499-2510 (2010).
113. Schulman, S. et al. Dabigatran versus warfarin in the treatment of acute venous thromboembolism. N. Engl. J. Med. 361, 2342-2352 (2009).
114. Agnelli, G. et al. Apixaban for extended treatment of venous thromboembolism. N. Engl. J. Med. 368, 699-708 (2013).
115. Bechmann, L. P. et al. Low-molecular-weight heparin in patients with advanced cirrhosis. Liver Int. 31, 75-82 (2011).
116. Lisman, T. & Porte, R. J. Towards a rational use of low-molecular-weight heparin in patients with cirrhosis. Liver Int. 31, 1063 (2011).
117. Senzolo, M. et al. Increased anticoagulant response to low-molecular-weight heparin in plasma from patients with advanced cirrhosis. J. Thromb. Haemost. 10, 1823-1829 (2012).
118. Qi, X., Han, G., Wu, K. & Fan, D. Anticoagulation for portal vein thrombosis in cirrhosis. Am. J. Med. 123, e19-e20 (2010).
119. De Santis, A. et al. Systemic thrombolysis of portal vein thrombosis in cirrhotic patients: a pilot study. Dig. Liver Dis. 42, 451-455 (2010).
120. Bizollon, T., Bissuel, F., Detry, L. & Trepo, C. Fibrinolytic therapy for portal vein thrombosis. Lancet 337, 1416 (1991).
121. Smalberg, J. H. et al. Risks and benefits of transcatheter thrombolytic therapy in patients with splanchnic venous thrombosis. Thromb. Haemost. 100, 1084-1088 (2008).
122. Liu, F. Y. et al. Interventional treatment for symptomatic acute-subacute portal and superior mesenteric vein thrombosis. World J. Gastroenterol. 15, 5028-5034 (2009).
123. Cao, G. et al. Treatment of postoperative main portal vein and superior mesenteric vein thrombosis with balloon angioplasty and/or stent placement. Acta Radiol. http://dx.doi.org/10.1177/0284185113475917.
124. Chu, H. H. et al. Percutaneous transsplenic access to the portal vein for management of vascular complication in patients with chronic liver disease. Cardiovasc. Intervent. Radiol. 35, 1388-1395 (2012).
125. Zhu, K. et al. Percutaneous transsplenic portal vein catheterization: technical procedures, safety, and clinical applications. J. Vasc. Interv. Radiol. 24, 518-527 (2013).
126. Qi, X., Han, G. & Fan, D. The preferable treatment for cirrhotic portal vein thrombosis: anticoagulation or transjugular intrahepatic portosystemic shunt? Hepatology 51, 713-714 (2010).
127. Riggio, O., Ridola, L., Lucidi, C. & Angeloni, S. Emerging issues in the use of transjugular intrahepatic portosystemic shunt (TIPS) for management of portal hypertension: time to update the guidelines? Dig. Liver Dis. 42, 462-467 (2010).
128. Luca, A. et al. Short- and long-term effects of the transjugular intrahepatic portosystemic shunt on portal vein thrombosis in patients with cirrhosis. Gut 60, 846-852 (2011).
129. Han, G. et al. Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with symptomatic portal hypertension in liver cirrhosis. J. Hepatol. 54, 78-88 (2011).
130. Perarnau, J. M., Baju, A., D'Alteroche, L., Viguier, J. & Ayoub, J. Feasibility and long-term evolution of TIPS in cirrhotic patients with portal thrombosis. Eur. J. Gastroenterol. Hepatol. 22, 1093-1098 (2010).
131. Van Ha, T. G. et al. Transjugular intrahepatic portosystemic shunt placement in patients with cirrhosis and concomitant portal vein thrombosis. Cardiovasc. Intervent. Radiol. 29, 785-790 (2006). (Pubitemid 44128010)
132. Senzolo, M. et al. Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with and without cavernous transformation. Aliment. Pharmacol. Ther. 23, 767-775 (2006). (Pubitemid 43344596)
133. Blum, U. et al. Noncavernomatous portal vein thrombosis in hepatic cirrhosis: treatment with transjugular intrahepatic portosystemic shunt and local thrombolysis. Radiology 195, 153-157 (1995).
134. Gaba, R. C. & Parvinian, A. Transjugular intrahepatic portosystemic shunt for maintenance of portal venous patency in liver transplant candidates. J. Clin. Imaging Sci. 3, 28 (2013).
135. Matsui, O. et al. Transjugular intrahepatic portosystemic shunt after previous recanalization of a chronically thrombosed portal vein via a transmesenteric approach. Cardiovasc. Intervent. Radiol. 19, 352-355 (1996). (Pubitemid 26358954)
136. Senzolo, M., Burra, P., Patch, D. & Burroughs, A. K. Tips for portal vein thrombosis (pvt) in cirrhosis: not only unblocking a pipe. J. Hepatol. 55, 945-946 (2011).
137. Bureau, C. et al. Patency of stents covered with polytetrafluoroethylene in patients treated by transjugular intrahepatic portosystemic shunts: long-term results of a randomized multicentre study. Liver Int. 27, 742-747 (2007). (Pubitemid 47062040)
138. Yang, Z. et al. Patency and clinical outcomes of transjugular intrahepatic portosystemic shunt with polytetrafluoroethylene-covered stents versus bare stents: a meta-analysis. J. Gastroenterol. Hepatol. 25, 1718-1725 (2010).
139. Rössle, M. TIPS: 25 years later. J. Hepatol. 59, 1081-1093 (2013).
140. US National Library of Medicine. ClinicalTrials.gov [online], http://clinicaltrials.gov/ct2/show/NCT01326949?term=NCT01326949&rank=1.
141. Qi, X. et al. Transjugular intrahepatic portosystemic shunt for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis: study protocol for a randomised controlled trial. BMJ Open 3 (2013).
142. Qi, X. et al. Transjugular intrahepatic portosystemic shunt may be superior to conservative therapy for variceal rebleeding in cirrhotic patients with non-tumoral portal vein thrombosis: a hypothesis. Med. Sci. Monit. 18, HY37-HY41 (2012).
143. Qi, X., Han, G. & Fan, D. Degree of portal vein thrombosis might be associated with recanalization during anticoagulation. Clin. Gastroenterol. Hepatol. 10, 820 (2012).
144. Francoz, C., Valla, D. & Durand, F. Portal vein thrombosis, cirrhosis, and liver transplantation. J. Hepatol. 57, 203-212 (2012).