Initial management of noncirrhotic splanchnic vein thrombosis: When is anticoagulation enough?

Pranavi Ravichandran, Kris P. Croome, Michael J. Kovacs, Alejandro Lazo-Langner, Roberto Hernandez-Alejandro

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The optimal initial treatment of splanchnic vein thrombosis is uncertain. Anticoagulant therapy has been shown to be associated with vessel recanalization and decreased recurrence. Furthermore, information regarding potential predictors of chronic complications is not well understood. Methods: A retrospective cohort study involving consecutive patients diagnosed with first-episode noncirrhotic splanchnic vein thrombosis referred to the thrombosis clinic of the authors' institution between 2008 and 2011 was conducted. Demographic and clinical information was collected. The response to initial anticoagulant therapy was evaluated by determining radiographic recanalization of vessels and clinical resolution (defined as the absence of ongoing splanchnic vein thrombosis symptoms or complications requiring treatment beyond anticoagulant therapy). Results: Twenty-two patients were included. Anticoagulant therapy alone resulted in vessel recanalization in 41% of patients and 68% achieved clinical resolution. Two patients experienced bleeding events. Factors associated with a lack of clinical resolution included signs of portal hypertension/liver failure on presentation, complete vessel occlusion at diagnosis, presence of a myeloproliferative disorder or JAK2V617F tyrosine kinase mutation and the absence of a local/transient predisposing factor. Conclusions: Anticoagulant therapy appeared to be an effective initial treatment in patients with splanchnic vein thrombosis. Clinical factors may help to identify patients who are at risk for developing complications thus requiring closer monitoring. These findings were limited by the small sample size and need to be explored in larger prospective studies.

Original languageEnglish (US)
Pages (from-to)207-211
Number of pages5
JournalCanadian Journal of Gastroenterology and Hepatology
Volume28
Issue number4
StatePublished - 2014
Externally publishedYes

Fingerprint

Viscera
Veins
Thrombosis
Anticoagulants
Therapeutics
Myeloproliferative Disorders
Liver Failure
Portal Hypertension
Causality
Sample Size
Protein-Tyrosine Kinases
Cohort Studies
Retrospective Studies
Demography
Prospective Studies
Hemorrhage
Recurrence
Mutation

Keywords

  • Anticoagulation
  • Portal hypertension
  • Splanchnic vein thrombosis
  • Therapy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Ravichandran, P., Croome, K. P., Kovacs, M. J., Lazo-Langner, A., & Hernandez-Alejandro, R. (2014). Initial management of noncirrhotic splanchnic vein thrombosis: When is anticoagulation enough? Canadian Journal of Gastroenterology and Hepatology, 28(4), 207-211.

Initial management of noncirrhotic splanchnic vein thrombosis : When is anticoagulation enough? / Ravichandran, Pranavi; Croome, Kris P.; Kovacs, Michael J.; Lazo-Langner, Alejandro; Hernandez-Alejandro, Roberto.

In: Canadian Journal of Gastroenterology and Hepatology, Vol. 28, No. 4, 2014, p. 207-211.

Research output: Contribution to journalArticle

Ravichandran, P, Croome, KP, Kovacs, MJ, Lazo-Langner, A & Hernandez-Alejandro, R 2014, 'Initial management of noncirrhotic splanchnic vein thrombosis: When is anticoagulation enough?', Canadian Journal of Gastroenterology and Hepatology, vol. 28, no. 4, pp. 207-211.
Ravichandran P, Croome KP, Kovacs MJ, Lazo-Langner A, Hernandez-Alejandro R. Initial management of noncirrhotic splanchnic vein thrombosis: When is anticoagulation enough? Canadian Journal of Gastroenterology and Hepatology. 2014;28(4):207-211.
Ravichandran, Pranavi ; Croome, Kris P. ; Kovacs, Michael J. ; Lazo-Langner, Alejandro ; Hernandez-Alejandro, Roberto. / Initial management of noncirrhotic splanchnic vein thrombosis : When is anticoagulation enough?. In: Canadian Journal of Gastroenterology and Hepatology. 2014 ; Vol. 28, No. 4. pp. 207-211.
@article{ba917a546df04418b4ee5e5e9fcb7539,
title = "Initial management of noncirrhotic splanchnic vein thrombosis: When is anticoagulation enough?",
abstract = "Background: The optimal initial treatment of splanchnic vein thrombosis is uncertain. Anticoagulant therapy has been shown to be associated with vessel recanalization and decreased recurrence. Furthermore, information regarding potential predictors of chronic complications is not well understood. Methods: A retrospective cohort study involving consecutive patients diagnosed with first-episode noncirrhotic splanchnic vein thrombosis referred to the thrombosis clinic of the authors' institution between 2008 and 2011 was conducted. Demographic and clinical information was collected. The response to initial anticoagulant therapy was evaluated by determining radiographic recanalization of vessels and clinical resolution (defined as the absence of ongoing splanchnic vein thrombosis symptoms or complications requiring treatment beyond anticoagulant therapy). Results: Twenty-two patients were included. Anticoagulant therapy alone resulted in vessel recanalization in 41{\%} of patients and 68{\%} achieved clinical resolution. Two patients experienced bleeding events. Factors associated with a lack of clinical resolution included signs of portal hypertension/liver failure on presentation, complete vessel occlusion at diagnosis, presence of a myeloproliferative disorder or JAK2V617F tyrosine kinase mutation and the absence of a local/transient predisposing factor. Conclusions: Anticoagulant therapy appeared to be an effective initial treatment in patients with splanchnic vein thrombosis. Clinical factors may help to identify patients who are at risk for developing complications thus requiring closer monitoring. These findings were limited by the small sample size and need to be explored in larger prospective studies.",
keywords = "Anticoagulation, Portal hypertension, Splanchnic vein thrombosis, Therapy",
author = "Pranavi Ravichandran and Croome, {Kris P.} and Kovacs, {Michael J.} and Alejandro Lazo-Langner and Roberto Hernandez-Alejandro",
year = "2014",
language = "English (US)",
volume = "28",
pages = "207--211",
journal = "Canadian Journal of Gastroenterology and Hepatology",
issn = "2291-2789",
publisher = "Pulsus Group Inc.",
number = "4",

}

TY - JOUR

T1 - Initial management of noncirrhotic splanchnic vein thrombosis

T2 - When is anticoagulation enough?

AU - Ravichandran, Pranavi

AU - Croome, Kris P.

AU - Kovacs, Michael J.

AU - Lazo-Langner, Alejandro

AU - Hernandez-Alejandro, Roberto

PY - 2014

Y1 - 2014

N2 - Background: The optimal initial treatment of splanchnic vein thrombosis is uncertain. Anticoagulant therapy has been shown to be associated with vessel recanalization and decreased recurrence. Furthermore, information regarding potential predictors of chronic complications is not well understood. Methods: A retrospective cohort study involving consecutive patients diagnosed with first-episode noncirrhotic splanchnic vein thrombosis referred to the thrombosis clinic of the authors' institution between 2008 and 2011 was conducted. Demographic and clinical information was collected. The response to initial anticoagulant therapy was evaluated by determining radiographic recanalization of vessels and clinical resolution (defined as the absence of ongoing splanchnic vein thrombosis symptoms or complications requiring treatment beyond anticoagulant therapy). Results: Twenty-two patients were included. Anticoagulant therapy alone resulted in vessel recanalization in 41% of patients and 68% achieved clinical resolution. Two patients experienced bleeding events. Factors associated with a lack of clinical resolution included signs of portal hypertension/liver failure on presentation, complete vessel occlusion at diagnosis, presence of a myeloproliferative disorder or JAK2V617F tyrosine kinase mutation and the absence of a local/transient predisposing factor. Conclusions: Anticoagulant therapy appeared to be an effective initial treatment in patients with splanchnic vein thrombosis. Clinical factors may help to identify patients who are at risk for developing complications thus requiring closer monitoring. These findings were limited by the small sample size and need to be explored in larger prospective studies.

AB - Background: The optimal initial treatment of splanchnic vein thrombosis is uncertain. Anticoagulant therapy has been shown to be associated with vessel recanalization and decreased recurrence. Furthermore, information regarding potential predictors of chronic complications is not well understood. Methods: A retrospective cohort study involving consecutive patients diagnosed with first-episode noncirrhotic splanchnic vein thrombosis referred to the thrombosis clinic of the authors' institution between 2008 and 2011 was conducted. Demographic and clinical information was collected. The response to initial anticoagulant therapy was evaluated by determining radiographic recanalization of vessels and clinical resolution (defined as the absence of ongoing splanchnic vein thrombosis symptoms or complications requiring treatment beyond anticoagulant therapy). Results: Twenty-two patients were included. Anticoagulant therapy alone resulted in vessel recanalization in 41% of patients and 68% achieved clinical resolution. Two patients experienced bleeding events. Factors associated with a lack of clinical resolution included signs of portal hypertension/liver failure on presentation, complete vessel occlusion at diagnosis, presence of a myeloproliferative disorder or JAK2V617F tyrosine kinase mutation and the absence of a local/transient predisposing factor. Conclusions: Anticoagulant therapy appeared to be an effective initial treatment in patients with splanchnic vein thrombosis. Clinical factors may help to identify patients who are at risk for developing complications thus requiring closer monitoring. These findings were limited by the small sample size and need to be explored in larger prospective studies.

KW - Anticoagulation

KW - Portal hypertension

KW - Splanchnic vein thrombosis

KW - Therapy

UR - http://www.scopus.com/inward/record.url?scp=84902649362&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902649362&partnerID=8YFLogxK

M3 - Article

C2 - 24729995

AN - SCOPUS:84902649362

VL - 28

SP - 207

EP - 211

JO - Canadian Journal of Gastroenterology and Hepatology

JF - Canadian Journal of Gastroenterology and Hepatology

SN - 2291-2789

IS - 4

ER -