본문 바로가기
KERD
논문KCI 등재

간문맥 혈전증: 역학, 진단 및 치료에 관하여

Epidemiology, Diagnosis, and Treatment of Portal Vein Thrombosis

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류내과학

초록

In recent years, the incidence of portal vein thrombosis (PVT) in patients with cirrhosis has increased; the thrombosis ranges from asymptomatic partial to complete occlusion. Treatment is difficult. Anticoagulation therapy may be the optimal first-line treatment for patients with acute PVT who lack variceal bleeding or mesenteric ischemia. Minimally invasive treatment options include mechanical thrombectomy, chemical thrombolysis, and stent placement. However, the effectiveness and timing of anticoagulation and interventional therapies remain unclear.

Abstract

In recent years, the incidence of portal vein thrombosis (PVT) in patients with cirrhosis has increased; the thrombosis ranges from asymptomatic partial to complete occlusion. Treatment is difficult. Anticoagulation therapy may be the optimal first-line treatment for patients with acute PVT who lack variceal bleeding or mesenteric ischemia. Minimally invasive treatment options include mechanical thrombectomy, chemical thrombolysis, and stent placement. However, the effectiveness and timing of anticoagulation and interventional therapies remain unclear.

참고문헌 (72)

  1. Faccia M, "Portal vein thrombosis in cirrhosis : why a well-known complication is still matter of debate", World J Gastroenterol, 25, pp.4437~4451 (2019)
  2. Zocco MA, "Thrombotic risk factors in patients with liver cirrhosis : correlation with MELD scoring system and portal vein thrombosis development", J Hepatol, 51, pp.682~689 (2009)
  3. Stine JG, "Increased risk of portal vein thrombosis in patients with cirrhosis due to nonalcoholic steatohepatitis", Liver Transpl, 21, pp.1016~1021 (2015)
  4. Francoz C, "Portal vein thrombosis, cirrhosis, and liver transplantation", J Hepatol, 57, pp.203~212 (2012)
  5. Rodríguez-Castro KI, "Management of nonneoplastic portal vein thrombosis in the setting of liver transplantation : a systematic review", Transplantation, 94, pp.1145~1153 (2012)
  6. Noronha Ferreira C, "Anticoagulation in cirrhosis and portal vein thrombosis is safe and improves prognosis in advanced cirrhosis", Dig Dis Sci, 64, pp.2671~2683 (2019)
  7. Loudin M, "Portal vein thrombosis in cirrhosis", J Clin Gastroenterol, 51, pp.579~585 (2017)
  8. Qi X, "Management of portal vein thrombosis in liver cirrhosis", Nat Rev Gastroenterol Hepatol, 11, pp.435~446 (2014)
  9. Sarin SK, "Consensus on extra-hepatic portal vein obstruction", Liver Int, 26, pp.512~519 (2006)
  10. Valla DC, "Spectrum of portal vein thrombosis in the West", J Gastroenterol Hepatol, 17(;Suppl 3), pp.S224~S227 (2002)
  11. Gertsch P, "Acute thrombosis of the splanchnic veins", Arch Surg, 128, pp.341~345 (1993)
  12. Valeriani E, "Splanchnic vein thrombosis : current perspectives", Vasc Health Risk Manag, 15, pp.449~461 (2019)
  13. Thatipelli MR, "Survival and recurrence in patients with splanchnic vein thromboses", Clin Gastroenterol Hepatol, 8, pp.200~205 (2010)
  14. Alzubaidi S, "Current concepts in portal vein thrombosis : etiology, clinical presentation and management", Abdom Radiol(NY), 44, pp.3453~3462 (2019)
  15. Chandra R, "Portal biliopathy", J Gastroenterol Hepatol, 16, pp.1086~1092 (2001)
  16. Northup PG, "Vascular liver disorders, portal vein thrombosis, and procedural bleeding in patients with liver disease : 2020 practice guidance by the American Association for the Study of Liver Diseases", Hepatology, 73, pp.366~413 (2021)
  17. Stieber AC, "The spectrum of portal vein thrombosis in liver transplantation", Ann Surg, 213, pp.199~206 (1991)
  18. Nonami T, "The incidence of portal vein thrombosis at liver transplantation", Hepatology, 16, pp.1195~1198 (1992)
  19. Gayowski TJ, "A high incidence of native portal vein thrombosis in veterans undergoing liver transplantation", J Surg Res, 60, pp.333~338 (1996)
  20. Yerdel MA, "Portal vein thrombosis in adults undergoing liver transplantation : risk factors, screening, management, and outcome", Transplantation, 69, pp.1873~1881 (2000)
  21. Jamieson NV, "Changing perspectives in portal vein thrombosis and liver transplantation", Transplantation, 69, pp.1772~1774 (2000)
  22. Charco R, "Portal vein thrombosis in liver transplantation", Transplant Proc, 37, pp.3904~3905 (2005)
  23. Bauer J, "The role of TIPS for portal vein patency in liver transplant patients with portal vein thrombosis", Liver Transpl, 12, pp.1544~1551 (2006)
  24. Ma J, "Rational classification of portal vein thrombosis and its clinical significance", PLoS One, 9, pp.e112501~ (2014)
  25. Sarin SK, "Toward a comprehensive new classification of portal vein thrombosis in patients with cirrhosis", Gastroenterology, 151, pp.574~577 (2016)
  26. Bhangui P, "Novel classification of non-malignant portal vein thrombosis : a guide to surgical decision-making during liver transplantation", J Hepatol, 71, pp.1038~1050 (2019)
  27. Kumar DR, "Virchow's contribution to the understanding of thrombosis and cellular biology", Clin Med Res, 8, pp.168~172 (2010)
  28. Monroe DM, "The coagulation cascade in cirrhosis", Clin Liver Dis, 13, pp.1~9 (2009)
  29. Mikuła T, "Serum ADAMTS-13 levels as an indicator of portal vein thrombosis", Gastroenterol Res Pract, 2018, pp.3287491~ (2018)
  30. Violi F, "Ongoing prothrombotic state in the portal circulation of cirrhotic patients", Thromb Haemost, 77, pp.44~47 (1997)
  31. Wosiewicz P, "Portal vein thrombosis in cirrhosis is not associated with intestinal barrier disruption or increased platelet aggregability", Clin Res Hepatol Gastroenterol, 40, pp.722~729 (2016)
  32. DeLeve LD, "Vascular disorders of the liver", Hepatology, 49, pp.1729~1764 (2009)
  33. Anton A, "The pathophysiology of portal vein thrombosis in cirrhosis : getting deeper into Virchow's triad", J Clin Med, 11, pp.800~ (2022)
  34. Loffredo L, "Effects of anticoagulants in patients with cirrhosis and portal vein thrombosis : a systematic review and meta-analysis", Gastroenterology, 153, pp.480~487 (2017)
  35. Nery F, "Causes and consequences of portal vein thrombosis in 1, 243 patients with cirrhosis : results of a longitudinal study", Hepatology, 61, pp.660~667 (2015)
  36. Zhang D, "Protein C and D-dimer are related to portal vein thrombosis in patients with liver cirrhosis", J Gastroenterol Hepatol, 25, pp.116~121 (2010)
  37. Cheng XQ, "Portal vein aneurysms with multiple associated findings", Vasa, 39, pp.312~318 (2010)
  38. Thornburg B, "Pretransplantation portal vein recanalization and transjugular intrahepatic portosystemic shunt creation for chronic portal vein thrombosis : final analysis of a 61-patient cohort", J Vasc Interv Radiol, 28, pp.1714~1721 (2017)
  39. Tublin ME, "Benign and malignant portal vein thrombosis : differentiation by CT characteristics", AJR Am J Roentgenol, 168, pp.719~723 (1997)
  40. Cerini F, "Impact of anticoagulation on upper-gastrointestinal bleeding in cirrhosis. A retrospective multicenter study", Hepatology, 62, pp.575~583 (2015)
  41. Qi X, "Anticoagulation for the treatment of portal vein thrombosis in liver cirrhosis : a systematic review and meta-analysis of observational studies", Eur J Intern Med, 26, pp.23~29 (2015)
  42. Pettinari I, "Clinical impact and safety of anticoagulants for portal vein thrombosis in cirrhosis", Am J Gastroenterol, 114, pp.258~266 (2019)
  43. Delgado MG, "Efficacy and safety of anticoagulation on patients with cirrhosis and portal vein thrombosis", Clin Gastroenterol Hepatol, 10, pp.776~783 (2012)
  44. Amitrano L, "Safety and efficacy of anticoagulation therapy with low molecular weight heparin for portal vein thrombosis in patients with liver cirrhosis", J Clin Gastroenterol, 44, pp.448~451 (2010)
  45. Senzolo M, "Prospective evaluation of anticoagulation and transjugular intrahepatic portosystemic shunt for the management of portal vein thrombosis in cirrhosis", Liver Int, 32, pp.919~927 (2012)
  46. Rodriguez-Castro KI, "A prediction model for successful anticoagulation in cirrhotic portal vein thrombosis", Eur J Gastroenterol Hepatol, 31, pp.34~42 (2019)
  47. Francoz C, "Splanchnic vein thrombosis in candidates for liver transplantation : usefulness of screening and anticoagulation", Gut, 54, pp.691~697 (2005)
  48. Turon F, "Portal vein thrombosis : yes or no on anticoagulation therapy", Curr Opin Organ Transplant, 23, pp.250~256 (2018)
  49. Simonetto DA, "ACG clinical guideline : disorders of the hepatic and mesenteric circulation", Am J Gastroenterol, 115, pp.18~40 (2020)
  50. Odriozola A, "Portal vein thrombosis in the setting of cirrhosis : a comprehensive review", J Clin Med, 11, pp.6435~ (2022)
  51. Cui SB, "Efficacy and safety of anticoagulation therapy with different doses of enoxaparin for portal vein thrombosis in cirrhotic patients with hepatitis B", Eur J Gastroenterol Hepatol, 27, pp.914~919 (2015)
  52. 정정화, "Safety, efficacy, and response predictors of anticoagulation for the treatment of nonmalignant portal-vein thrombosis in patients with cirrhosis: a propensity score matching analysis", Clinical and Molecular Hepatology, 20(4), pp.384~391 (2014), 대한간학회
  53. Chen H, "Efficacy and safety of anticoagulation in more advanced portal vein thrombosis in patients with liver cirrhosis", Eur J Gastroenterol Hepatol, 28, pp.82~89 (2016)
  54. Cai M, "Portal vein thrombosis after partial splenic embolization in liver cirrhosis : efficacy of anticoagulation and long-term follow-up", J Vasc Interv Radiol, 24, pp.1808~1816 (2013)
  55. Hanafy AS, "Randomized controlled trial of rivaroxaban versus warfarin in the management of acute non-neoplastic portal vein thrombosis", Vascul Pharmacol, 113, pp.86~91 (2019)
  56. La Mura V, "Harmful and beneficial effects of anticoagulants in patients with cirrhosis and portal vein thrombosis", Clin Gastroenterol Hepatol, 16, pp.1146~1152 (2018)
  57. de Franchis R, "Baveno VII-Renewing consensus in portal hypertension", J Hepatol, 76, pp.959~974 (2022)
  58. Nagaoki Y, "Efficacy and safety of edoxaban for treatment of portal vein thrombosis following danaparoid sodium in patients with liver cirrhosis", Hepatol Res, 48, pp.51~58 (2018)
  59. Ai MH, "Efficacy and safety study of direct-acting oral anticoagulants for the treatment of chronic portal vein thrombosis in patients with liver cirrhosis", Eur J Gastroenterol Hepatol, 32, pp.1395~1400 (2020)
  60. Nisly SA, "Safety of direct oral anticoagulants in patients with mild to moderate cirrhosis : a systematic review and meta-analysis", J Thromb Thrombolysis, 52, pp.817~827 (2021)
  61. Chamarthy MR, "Thrombolysis and transjugular intrahepatic portosystemic shunt creation for acute and subacute portal vein thrombosis", Tech Vasc Interv Radiol, 19, pp.42~51 (2016)
  62. Kwon J, "Low-molecular-weight heparin treatment for portal vein thrombosis in liver cirrhosis : efficacy and the risk of hemorrhagic complications", Thromb Res, 163, pp.71~76 (2018)
  63. Uflacker R, "Applications of percutaneous mechanical thrombectomy in transjugular intrahepatic portosystemic shunt and portal vein thrombosis", Tech Vasc Interv Radiol, 6, pp.59~69 (2003)
  64. Lichtenberg MKW, "Endovascular mechanical thrombectomy versus thrombolysis in patients with iliofemoral deep vein thrombosis-a systematic review and meta-analysis", Vasa, 50, pp.59~67 (2021)
  65. Cai G, "AngioJet aspiration thrombectomy combined with transcatheter thrombolysis in treatment of acute portal venous systemic thrombosis", Ann Vasc Surg, 66, pp.362~369 (2020)
  66. Seedial SM, "Acute portal vein thrombosis : current trends in medical and endovascular management", Semin Intervent Radiol, 35, pp.198~202 (2018)
  67. Abdel-Aal AK, "Endovascular treatment of acute portal vein thrombosis using ultrasound-accelerated catheter-directed thrombolysis", Vasc Endovascular Surg, 48, pp.460~465 (2014)
  68. Luca A, "Short-and long-term effects of the transjugular intrahepatic portosystemic shunt on portal vein thrombosis in patients with cirrhosis", Gut, 60, pp.846~852 (2011)
  69. Davis JPE, "Anticoagulation and transjugular intrahepatic portosystemic shunting for treatment of portal vein thrombosis in cirrhosis : a systematic review and meta-analysis", Clin Appl Thromb Hemost, 25, pp.1076029619888026~ (2019)
  70. Stine JG, "Decreased portal vein velocity is predictive of the development of portal vein thrombosis : a matched case-control study", Liver Int, 38, pp.94~101 (2018)
  71. Lv Y, "Covered TIPS versus endoscopic band ligation plus propranolol for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis : a randomised controlled trial", Gut, 67, pp.2156~2168 (2018)
  72. Luo X, "Advanced cirrhosis combined with portal vein thrombosis : a randomized trial of TIPS versus endoscopic band ligation plus propranolol for the prevention of recurrent esophageal variceal bleeding", Radiology, 276, pp.286~293 (2015)

관련 논문AI추천

Safety, efficacy, and response predictors of anticoagulation for the treatment of nonmalignant portal-vein thrombosis in patients with cirrhosis: a propensity score matching analysis김기현, 김진욱, 옥경삼, 이종호, 장은선, 정숙향, 정정화대한간학회 · Clinical and Molecular Hepatology2014 · 제20권 제4호Update in the treatment of cirrhotic patients with portal vein thrombosisBonan Chen, Fuda Xie, Ge Zhang, Hoi Wing Leung, Jialin Wu, Junyang Luo, Ka Fai To, Wei Kang, Xinyi Deng, Zaibo Jiang대한간학회 · Clinical and Molecular Hepatology2025 · 제31권 제4호Treatment of direct oral anticoagulants in patients with liver cirrhosis and portal vein thrombosis이민종, 조유리, A Reum Choe, Ho Soo Chun, Hwi Young Kim, Kwon Yoo, Tae Hun Kim대한간학회 · Clinical and Molecular Hepatology2021 · 제27권 제4호Recurrent acute portal vein thrombosis in liver cirrhosis treated by rivaroxaban김서리, 송명준, 양혜영대한간학회 · Clinical and Molecular Hepatology2016 · 제22권 제4호간문맥혈전증을 동반한 특발성 문맥고혈압 환자에서 Protein C, Protein S 결핍 1예김도영, 김민주, 박영년, 박준용, 안상훈, 이현정, 전영은, 전재윤, 한광협, 황세나대한간학회 · Clinical and Molecular Hepatology2010 · 제16권 제2호식도정맥류 출혈에 내시경적 경화요법 후 합병된 상 장간막 정맥 혈전증 1예김원덕, 최광해, 하정옥영남대학교 의과대학 · Journal of Yeungnam Medical Science2001 · 제18권 제2호

이 간행물의 다른 논문 (7건)