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Cited by 202Venous Thromboembolism Diagnosis and ManagementAbdominal vascular conditions and treatmentsLiver Disease and Transplantation

Survival and Recurrence in Patients With Splanchnic Vein Thromboses

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Thatipelli, Mallikarjun R., McBane, Robert D., Hodge, David O., Wysokinski, Waldemar E.·2010·Clinical Gastroenterology and Hepatology
DOI 10.1016/j.cgh.2009.09.019
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Abstract

Background & aims Hepatic, splenic, portal, and mesenteric veins are confluent elements within the splanchnic system. It is therefore unclear whether thromboses of isolated segments represent unique entities. We compared etiologies, recurrence, and survival of patients with thromboses of different splanchnic venous segments. Methods An inception cohort of individuals was identified with first lifetime incident of splanchnic vein thrombosis between 1980 and 2000. We performed a case-controlled comparison of recurrent thrombosis and survival data with those of patients with deep venous thrombosis (DVT). Results The study (832 patients; mean age, 53 +/- 17 years; 42% women) included patients with isolated portal (n = 329), mesenteric (n = 76), splenic (n = 62), and hepatic (n = 45) vein thrombosis and patients with multisegment involvement (n = 320). Malignancy (27%) and cirrhosis (24%) were the most common etiologies. Recurrence-free survival 10 years after splanchnic vein thrombosis (76%) was comparable with that after DVT (68%) and not improved by anticoagulant therapy. Hormone therapy was the only independent predictor of recurrence (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.09-4.45; P = .03). Major bleeding was 6.9/100 patient-years. Gastroesophageal varices (HR, 2.63; 95% CI, 1.72-4.03; P < .001) and warfarin therapy (HR, 1.91, 95% CI, 1.25-2.92; P = .003) were independent predictors of bleeding. The 10-year survival rate of patients with splanchnic vein thrombosis (60%) was lower than that of patients with DVT (68%, P < .05). Older age (HR, 1.03; 95% CI, 1.02-1.03), active cancer (HR, 2.23; 95% CI, 1.78-2.78), and myeloproliferative disorder (HR, 1.92; 95% CI, 1.41-2.61) were independent determinants of mortality (P < .001). Conclusions Splanchnic vein thrombosis depends on the pathology of the organ supplied. On the basis of the low rate of recurrence and substantial rate of major hemorrhage, prolonged anticoagulant therapy does not appear to be justified.

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Authors
Thatipelli, M. R., McBane, R. D., Hodge, D. O., & Wysokinski, W. E.
Affiliations
Mayo Clinic (US)
ORCID
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2010-02
Volume
8
Issue
2
Pages
200-205
ISSN
1542-3565 (ISSN-L)
DOI
10.1016/j.cgh.2009.09.019
OpenAlex
W2031156548
Cited by
201
References
23
Citations by year
2026: 8 · 2025: 9 · 2024: 15 · 2023: 16 · 2022: 13 · 2021: 11 · 2020: 17 · 2019: 5 · 2018: 15 · 2017: 16 · 2016: 13 · 2015: 16 · 2014: 16 · 2013: 15 · 2012: 7
FWCI
4.01
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Gastroenterology and Hepatology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
  • Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
Keywords
splanchnic vein thrombosis, portal vein thrombosis, mesenteric vein thrombosis, splenic vein thrombosis, hepatic vein thrombosis, recurrent thrombosis, survival, deep vein thrombosis, hormone therapy, major bleeding, gastroesophageal varices, warfarin, anticoagulation, myeloproliferative neoplasms
MeSH terms
Adult, Aged, Anticoagulants, Female, Hepatic Veins, Humans, Male, Mesenteric Veins, Middle Aged, Portal Vein, Recurrence, Splenic Vein, Thrombosis, Survival Analysis, Case-Control Studies

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