Portal vein thrombosis: diagnosis, management, and endpoints for future clinical studies.
СтатьяОбзорПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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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, Payancé Audrey, Plaforet Vincent, Plessier Aurélie, Poisson Johanne, Roberts Lara, Salem Riad, Sarin Shiv, Shukla Akash, Toso Christian, Tripathi Dhiraj, Valla Dominique, Ronot Maxime, Rautou Pierre-Emmanuel, ERN RARE-LIVER and VALDIG, an EASL consortium
Аннотация
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.