Portal vein thrombosis: diagnosis, management, and endpoints for future clinical studies.

Elkrief, Laure; Hernandez-Gea, Virginia; Senzolo, Marco; Albillos, Agustin; Baiges, Anna; Berzigotti, Annalisa; Bureau, Christophe; Murad, Sarwa Darwish; De Gottardi, Andrea; Durand, François; Garcia-Pagan, Juan-Carlos; Lisman, Ton; Mandorfer, Mattias; McLin, Valérie; Moga, Lucile; Nery, Filipe; Northup, Patrick; Nuzzo, Alexandre; Paradis, Valérie; Patch, David; ... (2024). Portal vein thrombosis: diagnosis, management, and endpoints for future clinical studies. The lancet. Gastroenterology & hepatology, 9(9), pp. 859-883. Elsevier 10.1016/S2468-1253(24)00155-9

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Portal vein thrombosis (PVT) refers to the development of a non-malignant obstruction of the portal vein, its branches, its radicles, or a combination. This Review first provides a comprehensive overview of all aspects of PVT, namely the specifics of the portal venous system, the risk factors for PVT, the pathophysiology of portal hypertension in PVT, the interest in non-invasive tests, as well as therapeutic approaches including the effect of treating risk factors for PVT or cause of cirrhosis, anticoagulation, portal vein recanalisation by interventional radiology, and prevention and management of variceal bleeding in patients with PVT. Specific issues are also addressed including portal cholangiopathy, mesenteric ischaemia and intestinal necrosis, quality of life, fertility, contraception and pregnancy, and PVT in children. This Review will then present endpoints for future clinical studies in PVT, both in patients with and without cirrhosis, agreed by a large panel of experts through a Delphi consensus process. These endpoints include classification of portal vein thrombus extension, classification of PVT evolution, timing of assessment of PVT, and global endpoints for studies on PVT including clinical outcomes. These endpoints will help homogenise studies on PVT and thus facilitate reporting, comparison between studies, and validation of future studies and trials on PVT.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine

UniBE Contributor:

Berzigotti, Annalisa

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2468-1253

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

17 Jul 2024 09:47

Last Modified:

12 Aug 2024 00:15

Publisher DOI:

10.1016/S2468-1253(24)00155-9

PubMed ID:

38996577

BORIS DOI:

10.48350/198996

URI:

https://boris.unibe.ch/id/eprint/198996

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