Background
Key points
“Transient PVT” as a distinct entity
Probability of transient PVT
First author, year (region) | Sex | Age (years) | Predisposing risk factors | Severity of thrombosis | Symptoms of thrombosis | Management | Outcomes | Interval from diagnosis to vessel patency |
---|---|---|---|---|---|---|---|---|
Borja, 2016 [25] (Singapore) | Female | 60 | Cryptogenic liver cirrhosis; invasive ductal carcinoma of left breast | Nonocclusive portal vein thrombus (< 50%) | Distended abdomen with ascites | Antibiotics; bedside ascitic fluid drainage; no antithrombotic treatment | Completely patent | 11 months |
Lai, 1997 [24] (Taiwan) | Male | 67 | Liver cirrhosis; esophageal transection and splenectomy | Nonocclusive portal vein thrombus within portal trunk and right portal vein | Ascites; icteric sclera | Conservative treatment with close observation; no antithrombotic treatment | Completely patent | 2 months |
Spahr, 1996 [23] (Canada) | Male | 45 | Alcoholic liver cirrhosis; accidental gallbladder puncture during transjugular liver biopsy | Thrombus within the right intrahepatic branch, left intrahepatic branch, main portal vein, and splenic vein (degree of thrombosis was unclear) | Slight epigastric discomfort | No invasive maneuvers, such as thrombolysis, were initiated. The patient was treated conservatively | Completely patent | 7 weeks |
First author, year (region) | Type of study | Enrollment period | Target population | Follow-up duration | Degree of PVT | Location of PVT | No. Pts | Severity of liver cirrhosis | Proportion of HCC | No. spontaneous recanalization or improvement | No. thrombus progression |
---|---|---|---|---|---|---|---|---|---|---|---|
Hidaka, 2018 [26] (Japan) | Multi-center, randomized, double-blind, placebo-controlled, full-text | Oct 2014 – Mar 2016 | LC with PVT | 21 ± 3 days | > 50% of the cross-sectional lumen of the MPV, portal vein branches, SMV, or SV | MPV (n = 20) Portal vein branch (n = 11) SV (n = 0) SMV (n = 5) | 36 | Child-Pugh A/B/C: 6/24/6 | 6 (16.7%) | 7 (19.4%) | 7 (19.4%) |
Chen, 2016 [27] (China) | Single-center, retrospective, controlled, full-text | Jan 2002 – Jun 2014 | LC with PVT | Mean ± SD: 25.9 ± 23 months (for 36 patients) | MPV (0–25%/26–50%/51–75%/76–100%): 8/2/6/20 LPV (0–50%/51–100%): 12/24 RPV (0–50%/51–100%): 11/25 SV (splenectomy/0–50%/51–100%): 20/11/5 SMV (0–50%/51–100%): 17/19 | 16 | Child-Pugh A/B/C: 8/21/2 Mean MELD score: 8.9 ± 3.01 (for 36 patients) | 0 (0%) | 4 (25%) | 6 (37.5%) | |
Nery,a 2015 [6] (France) | Multi-center, prospective, single-arm, full-text | Jun 2000 – Mar 2006 | Child-Pugh A and B LC with de novo PVT | Mean ± SD: 65.2 ± 39.6 months | Non-occlusive at the first diagnosis of PVT (n = 101); occlusive at the first diagnosis of PVT (n = 17) | NA | 101b | All patients had Child-Pugh A or B | 0 (0%) (for baseline) | 70 (70%) 89c (89%) | 14 (13.8%) |
Chung, 2014 [28] (Korea) | Single-center, retrospective, matched, controlled, full-text | 2003 – 2014 | LC with non-malignant partial PVT | NA | Partial (n = 14) | MPV (n = 9) RPV (n = 7) LPV (n = 4) SMV (n = 2) | 14 | Child-Pugh A/B/C: 7/6/1 | 8 (57.1%) | 5 (36%) | 3 (21.4%) |
Girleanu, 2014 [7] (Romania) | Single-center, prospective, single-arm, full-text | Jan 2011 – Oct 2013 | LC with non-malignant partial PVT | Mean ± SD (range): 20.22 ± 8.61 (4–31) months | Partial | PV (n = 18) PV + SMV (n = 11) PV + SMV + SV (n = 1) | 22 | Child-Pugh A/B/C: 7/9/6 Mean MELD score: 12.73 ± 4.34 | 0 (0%) | 5 (22.73%) | 6 (27.27%) |
Risso, 2014 [29] (Italy) | Single-center, retrospective, controlled, abstract | 2005 – 2011 | LC with pre-LT non-neoplastic PVT | NA | NA | NA | 20 | NA | NA | 8 (40%) | NA |
John, 2013 [8] (USA) | Single-center, prospective, single-arm, full-text | Jul 2004 – Jun 2009 | LC awaiting LT and PVT | > 6 months in all patients | Partial (n = 38); occlusive (n = 32) | MPV, not SMV | 70 | Mean MELD score: 14.4 ± 5.0 (for 47 pts. with baseline PVT); 15.3 ± 6.7 (for 23 pts. with new PVT) | 0 (0%) | 22 (31.4%) | 3 (4.3%) |
Maruyama, 2013 [9] (Japan) | Single-center, retrospective, single-arm, full-text | Jan 1998 – May 2009 | LC with de novo PVT | Mean ± SD (range): 65.2 ± 39.6 (0.87–136.4) months | Partial (n = 31); occlusive (n = 11) | Intrahepatic PV (n = 8) MPV (n = 15) SV (n = 6) MPV + intrahepatic PV (n = 9) MPV + SV (n = 2) MPV + SV + intrahepatic PV (n = 2) | 42 | Child-Pugh A/B/C: 14/22/6 Median MELD score: 10.6 | 0 (0%) | 20 (47.6%) | 3 (7.2%) |
Caracciolo, 2013 [30] (Italy) | Single-center, retrospective, matched, controlled, abstract | NA | LC with partial PVT | 6–12 months | Occlusion< 50% (n = 14) | NA | 14 | All patients had Child-Pugh A or B (no patient had Child-Pugh C) | 0 (0%) | 8 (57.6%) | NA |
Luca, 2012 [10] (Italy) | Single-center, retrospective, single-arm, full-text | Jan 2004 – Dec 2009 | LC with non-malignant, extrahepatic, partial PVT | Mean: 27 months; 3–6 months (n = 8); 6–12 months (n = 8); 12–24 months (n = 9); > 24 months (n = 19) | Occlusion: < 25% (n = 8) 25–50% (n = 11) 50–75% (n = 14) 75–90% (n = 9) | MPV (n = 15) MPV + SMV (n = 18) MPV + SMV + SV (n = 9) | 42 | Mean Child-Pugh score: 8.1 ± 1.9 Mean MELD score: 12.1 ± 2.9 | 0 (0%) | 19 (45%) | 20 (48%) |
Senzolo, 2012 [31] (UK) | Single-center, prospective, controlled, full-text | Jan 2007 – Jan 2008 | LC with PVT | Mean: 22.53 months | CTPV (n = 3) complete (n = 4) partial (n = 14) | Intrahepatic PV (n = 5) MPV (n = 21) SMV (n = 4) SV (n = 1) | 21 | Child-Pugh A/B/C: 5/9/7 Mean MELD score: 13.7 ± 3.6 | 0 (0%) | 1 (5%) | 15 (71.4%) |
Garcovich, 2011 [32] (Italy) | Single-center, retrospective, matched, controlled, abstract | NA | LC with PVT | NA | Occlusion> 75% (n = 3) | NA | 15 | All patients had Child-Pugh A or B (no patient had Child-Pugh C) | 0 (0%) | 5 (33%) | NA |
Francoz, 2005 [33] (France) | Single-center, retrospective, controlled, full-text | Jan 1996 – Dec 2001 | LC awaiting LT and partial PVT | NA | Partial (n = 10) | MPV (n = 6) RPV (n = 4) LPV (n = 3) | 10 | Child-Pugh A/B/C: 2/6/2 Mean MELD score: 11.8 ± 6.2 | 2/38 (5.3%) (for 38 patients with SVT) | 0 (0%) | 6 (60%) |
De Santis 2001 [34] (Italy) | Single-center, retrospective, single-arm, abstract | Jan 1996 – Dec 1999 | LC with PVT and without HCC | NA | NA | NA | 21 | NA | 0 (0%) | 7 (33%) | NA |