Portal vein thrombosis in cirrhosis: Controversies and latest developments

Table 2 Summary of studies reporting the use of anticoagulation for portal vein thrombosis in cirrhosis

	Study type	n (controls)	Baseline severity liver disease	Duration and type of anticoagulation	PVT characteristics(none/partial/complete occlusion)	Recanalisation	Partial recanalisation/ stabilisation	Progression	Bleeding complicaitons
Francoz et al[7]	Prospective case control	19 (10)	mean MELD 12.8	Warfarin (INR 2-3)	0/18/1	8/19 (42%) vs 0/10 non-anti-coagulated (P = 0.002)	0	1	1 bleeding episode following endoscopic variceal band ligation
				Mean 8.1 mo
Amitrano et al[83]	Prospective	28	?	Enoxaparin 200 IU/kg per day: 6 mo for responders and non-responders. Partial responders continue until end of follow up.	0/23/5	21 (75%) at median 11 mo	5 (17.9%)	2	Mild anaemia in patient with portal hypertensive gastropathy
Delgado et al[84]	Retrospective	55	mean MELD 12.8 +/- 3.8	Warfarin (INR 2-3) or enoxaparin mean 6.8 mo	0/41/14	25 (45.5%)	30 (54.5%)	0	6 variceal bleeds, 1 lower GI bleed, 1 obscure GI bleed, 1 oral bleed post-dental extraction, 1 severe vaginal bleed
Senzolo et al[85]	Prospective case control	33 (21)	MELD 12.6 (controls MELD 13.7)	Nadraparin low molecular weight heparin until end of follow up, or until 6 mo following complete recanalisation.	0/24/11	12/33 (36%) active arm vs 1/21 (5%) controls	Partial: 9/33 active arm. Stabilisation: 7/33 active arm. Partial recanalisation or stabilisation in 5/21 controls.	5/33 (14.3%) active arm vs 15/21 (71.4%) control arm (P < 0.001)	Active arm: 1 cerebral haemorrhage, 1 epistaxis, 1 haematuria, 1 variceal bleed
									Control arm: 5 variceal bleeds
Werner et al[86]	Retrospective	28	MELD 7-29	Warfarin	not described	11 (39.3%)	17 (60.7%)	0	1 significant vaginal bleed
				Mean 302 d
Villa et al[55]	Prospective randomised controlled trial	34 (36)	Child’s 7-10	Enoxaparin 4000 IU/d	Primary prevention study: No PVTs at baseline	N/A	N/A	Treatment arm: No PVT at 2 yr. Control arm: PVT in 10/36 (27.8%) at 2 yr (P = 0.001)	Active arm: 2 variceal bleeds, 2 epistaxis
				48 wk treatment. Follow up to 2 yr					Control arm: 1 variceal bleed, 1 epistaxis

PVT: Portal vein thrombosis.