1. Baseline characteristics and management of patients with splanchnic vein thrombosis: Results of an international registry
- Author
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Ageno, W., Riva, N., Schulman, S., Bang, S.-M., Sartori, M.T., Grandone, E., Beyer, J., Pasca, S., Di Minno, D., Duce, R., Malato, A., Santoro, R., Poli, D., Verhamme, P., Passamonti, S., Kamphuisen, P., Alatri, A., Becattini, C., Bucherini, E., Piana, A., De Stefano, V., Vidili, G., Bazzan, M., Di Nisio, M., Dentali, F., Martinelli, I., Barillari, G., Poggio, R., Colaizzo, D., Vaccarino, A., Cardiovascular Centre (CVC), and Vascular Ageing Programme (VAP)
- Subjects
diagnosis ,liver cirrhosis ,myeloproliferative neoplasm ,liver vein thrombosis ,splenic vein ,population ,anticoagulant agent ,gastrointestinal hemorrhage ,surgery ,ascites ,male ,vein ,follow up ,human ,portal vein thrombosis ,thrombosis ,register ,abdominal pain ,echography ,bleeding ,mortality ,clinical practice ,society ,female ,vein thrombosis ,risk factor ,mesenteric vein thrombosis ,solid ,hemostasis ,patient ,neoplasm ,blood clot lysis - Abstract
Background Splanchnic vein thrombosis (SVT) is a challenging disease. The aim of this international registry was to describe the characteristics of a large cohort of patients with SVT and their management in clinical practice. Patients and Methods Consecutive patients with objectively diagnosed SVT were eligible. Information on clinical presentations, diagnostic approaches, risk factors, and therapeutic strategies was collected. Results We included 613 patients from 12 countries. Mean age was 53.1 (SD±14.8) years (range 16-85); 62.6% were males, 74.4% Caucasians and 22.4% Asians. Overall, 470 patients had portal vein thrombosis, 266 had mesenteric vein thrombosis, 139 had splenic vein thrombosis, and 56 had supra-hepatic vein thrombosis. SVT occurred in multiple vein segments in 38.8% of patients. Abdominal pain was the most common symptom occurring in 55.0% of the patients; 10.4% of patients had ascites or increasing abdominal girth, 8.8% gastrointestinal bleeding at the time of diagnosis; in 29.8% of patients, SVT diagnosis was incidental. Objective diagnosis was obtained with abdominal CT in 70.7% of patients and with ultrasonography in 22.6%. Most common risk factors included cirrhosis (27.8%), solid cancer (22.3%), intra-abdominal inflammation/infection (11.5%), surgery (8.9%), and myeloproliferative neoplasm (MPN)(8.2%); in 27.6% of patients SVT was idiopathic. Patients with SVT secondary to solid cancer and cirrhosis were significantly older than other patient groups (mean age 60.8 and 58.5 vs. 48.5 years); female sex was more represented in MPN patients only (55.3%). During the acute phase, 77.5% of patients were treated with anticoagulant drugs; 21.2% were left untreated. Surgery was performed in 3.1%, thrombolysis in 1.5%. A 2-year follow up is currently ongoing to assess recurrent thrombosis, bleeding, and mortality. Comment SVT patients represent a heterogeneous population with variable baseline characteristics according to thrombosis site or major underlying risk factors. These differences have obvious prognostic implications and may drive different management strategies.
- Published
- 2012