Anticoagulants in Cirrhotic Patients: Controversies and Certainties in PVT Management

Title: Anticoagulants in Cirrhotic Patients: Controversies and Certainties in PVT Management

Volume: 9 Issue: 3

Author(s): Francesca R. Ponziani, Maria A. Zocco, Annalisa Tortora, Giovanni Gasbarrini and Antonio Gasbarrini

Affiliation:

Keywords: Anticoagulants, liver cirrhosis, portal vein thrombosis, coagulation system, vitamin k antagonists, warfarin, heparin, INR, bleeding, bowel ischemia, recanalization, pro-thormbotic disorders, portal vein thrombosis prevention, factor X inhibitors

Abstract: Portal vein thrombosis (PVT) is a relatively common event in patients with advanced-stage liver cirrhosis, even in patients with a compensated disease. Because of the protean clinical manifestation of PVT, ranging from massive variceal bleeding and mesenteric infarction to the complete absence of any symptom, it is mandatory to provide an early diagnosis and a prompt management. However, even if various treatments have been tested in clinical studies, most of them can be suitable only for a limited number of patients and anticoagulants are recognized as the gold standard, even if the debate about their use in PVT management in cirrhotic patients is still opened. In particular, “old” and “new” generations of anticoagulants have always been used carefully and, sometimes, with skepticism or diffidence in cirrhotic patients. In this review, we report the rationale of anticoagulants use in PVT cirrhotic patients management, analyzing the most accepted controversies and certainties, with a particular attention to their possible role as preemptive therapy.

Cite this article as:

R. Ponziani Francesca, A. Zocco Maria, Tortora Annalisa, Gasbarrini Giovanni and Gasbarrini Antonio, Anticoagulants in Cirrhotic Patients: Controversies and Certainties in PVT Management, Cardiovascular & Hematological Agents in Medicinal Chemistry 2011; 9 (3) . https://dx.doi.org/10.2174/187152511797037448