Anticoagulation and Vessel Recanalization in Cirrhotic Patients with Splanchnic Vein Thrombosis: A Multidisciplinary “Real Life” Experience

Figures & data

Figure 1 Baseline multi-disciplinary approach to SVT.

Abbreviations: AT, Anticoagulant treatment; CBC, Complete blood count; GFR, Glomerular filtration rate; EGD, Esophagogastroduodenoscopy; LMWH, Low Molecular Weight Heparin; VKA, Vitamin K Antagonists.

Figure 2 Follow-up schedule evaluation of SVT.

Abbreviations: AT, Anticoagulant treatment; CBC, Complete blood count; GFR, Glomerular filtration rate; EGD, Esophagogastroduodenoscopy.

Table 1 Main Characteristics of 119 Cirrhotic Patients at Diagnosis of SVT. Data are Expressed as Median (Interquartile Range) or Number (Percentage)

Age, years (median, range)	60 (18–90)
Gender, male (n, %)	91 (76%)
Family history of VTE (n, %)	1 (1%)
Clinical presentation (n, %)
Symptomatic	36 (32%)
Incidentally Detected	83 (68%)
Involved veins (n, %)
Portal VT	66 (55%)
Mesenteric VT	8 (7%)
Splenic VT	1 (1%)
Suprahepatic VT	3 (3%)
Multiple Veins	41 (34%)
JAK2 V617F or BCR/ABL + (n, %)	0 (0%)
Esophageal varices (n, %)
F1	34 (29%)
F2	44 (37%)
F3	13 (11%)
Solid Cancer (n, %)	48 (40%)
Hepatocarcinoma (n, %)	41 (35%)
Previous abdominal surgery (n, %)	10 (8%)
Abdominal inflammation/infection (n, %)	5 (4%)
Hormonal therapy (n, %)	3 (3%)
Abnormal trombophilia test (n, %)	20 (17%)
Cronic kidney disease (n, %)	24 (20%)
Platelet Count at diagnosis, n x 10*3 (median, range)	79 (27–558)
Child Pugh Score at diagnosis (n, %)
A	36 (30%)
B	59 (50%)
C	24 (20%)
MELD score at diagnosis (n, %)
<10	36 (30%)
10–18	69 (58%)
>18	14 (12%)

Abbreviations: IQR, interquartile range; SVT, splanchnic vein thrombosis; VTE, venous thromboembolism.

Table 2 Characteristics of Antithrombotic Treatments for Eligible Cirrhotic Patients. Data are Expressed as Median (Interquartile Range) or Number (Percentage)

AC treatment (n, %)	96 (81%)
LMWH treatment (n, %)	69 (72%)
- therapeutic dose (n)	40
- prophylactic dose (n)	29
VKA (n, %)	21 (22%)
- INR 2–3 (n)	14
- INR 1.8–2.5 (n)	6
- INR 1.8–2.2 (n)	1
Fondaparinux (n, %)	6 (6%)
- therapeutic dose (n)	5
- prophylactic dose (n)	1

Abbreviations: LMWH, Low-molecular-weight heparin; VKA, Vitamin K antagonist.

Figure 3 Overall survival of cirrhotic patients, according to TVS recanalization.

Table 3 Univariate and Multivariate Cox Regression Analysis of the Factors Affecting MELD Score Improvement

Variable	Univariate*			Multivariate
	p	OR	95% CI	p	OR	95% CI
Age (>60 years old vs <60 years old)	0.603	1.203	0.6–2.4
Ascites (yes vs no)	0.881	1.056	0.5–2.2
Esophageal Varices (yes vs no)	0.412	0.727	0.3–1.6
HCC or solid cancer (yes vs no)	0.619	1.209	0.6–2.6
At least partial recanalization (yes vs no)	0.043	2.720	1–7.2	0.03	2.62	1.1–6.47

Notes: *The factors with P < 0.05 in univariate analysis were enrolled into the forward stepwise multivariate Cox hazard regression.

Abbreviations: OR, Odds ratio; CI, confidence interval.