Fukushima journal of medical science · 2026
Treatment strategy for patients with cirrhosis complicated by esophageal varices and portal vein thrombosis.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kato Tsunetaka, Hikichi Takuto, Nakamura Jun, Yanagita Takumi, Otsuka Mitsuru, Kameoka Eisuke, Nemoto Daiki, Suzuki Rei, Sugimoto Mitsuru, Asama Hiroyuki, Shimizu Hiroshi, Osawa Kento, Ohira Rei, Kudo Keisuke, Ohira Hiromasa
Аннотация
UNLABELLED: ABSTRACTObjective : The optimal treatment strategy for patients with cirrhosis complicated by esophageal varices (EVs) and portal vein thrombosis (PVT) remains unclear. This study evaluated clinical outcomes according to treatment priority.
METHODS: We retrospectively analyzed patients with cirrhosis who had PVT confirmed by contrast-enhanced computed tomography before endoscopic injection sclerotherapy for EVs. Patients were categorized into EV-first and PVT-first groups, and changes in thrombus burden and clinical outcomes were compared.
RESULTS: Nineteen patients were included (EV-first, n = 10; PVT-first, n = 9). Baseline thrombus burden was greater in the PVT-first group. Thrombus reduction occurred more frequently in the PVT-first group (10% vs. 100%, p < 0.01). In the EV-first group, the maximum obstruction rate increased significantly (39.5% vs. 69%, p < 0.01), whereas it decreased in the PVT-first group (63% vs. 24%, p = 0.02). No variceal bleeding or other bleeding complications related to anticoagulant therapy or antithrombin III concentrate administration were observed during PVT treatment. After a median follow-up of 24 months, EV recurrence occurred only in the EV-first group and was associated with PVT enlargement.
CONCLUSIONS: In this retrospective cohort, favorable thrombus outcomes were observed in patients who underwent PVT-first treatment when variceal therapy could be safely deferred.
METHODS: We retrospectively analyzed patients with cirrhosis who had PVT confirmed by contrast-enhanced computed tomography before endoscopic injection sclerotherapy for EVs. Patients were categorized into EV-first and PVT-first groups, and changes in thrombus burden and clinical outcomes were compared.
RESULTS: Nineteen patients were included (EV-first, n = 10; PVT-first, n = 9). Baseline thrombus burden was greater in the PVT-first group. Thrombus reduction occurred more frequently in the PVT-first group (10% vs. 100%, p < 0.01). In the EV-first group, the maximum obstruction rate increased significantly (39.5% vs. 69%, p < 0.01), whereas it decreased in the PVT-first group (63% vs. 24%, p = 0.02). No variceal bleeding or other bleeding complications related to anticoagulant therapy or antithrombin III concentrate administration were observed during PVT treatment. After a median follow-up of 24 months, EV recurrence occurred only in the EV-first group and was associated with PVT enlargement.
CONCLUSIONS: In this retrospective cohort, favorable thrombus outcomes were observed in patients who underwent PVT-first treatment when variceal therapy could be safely deferred.