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Assessment of portal system hemodynamics for the prediction of portal vein thrombosis in cirrhosis-A systematic review and meta-analysis.
Giri, Suprabhat; Singh, Ankita; Kolhe, Kailash; Kozyk, Marko; Roy, Akash.
Affiliation
  • Giri S; Department of Gastroenterology & Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, India.
  • Singh A; Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, India.
  • Kolhe K; Department of Gastroenterology, Narayana Hospital, Nanded, India.
  • Kozyk M; Department of Internal Medicine, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA.
  • Roy A; Institute of Gastrosciences and Liver, Apollo Multispecialty Hospital, Kolkata, India.
J Clin Ultrasound ; 51(7): 1248-1258, 2023 Sep.
Article in En | MEDLINE | ID: mdl-37459439
BACKGROUND: The pathogenesis of portal vein thrombosis (PVT) in cirrhosis is multifactorial, with altered hemodynamics being proposed as a possible contributor. The present systematic review was conducted to study the role of assessment of portal hemodynamics for the prediction of PVT in patients with cirrhosis. METHODS: Three databases (Medline, Embase, and Scopus) were searched from inception to February 2023 for studies comparing portal venous system parameters in patients with cirrhosis developing PVT with those not. Results were presented as mean difference (MD) or odds ratio (OR) with their 95% confidence intervals (CIs). RESULTS: A total of 31 studies (patients with cirrhosis: 19 studies, patients with cirrhosis undergoing splenectomy: 12 studies) were included. On pooling the data from multivariable analyses of the included studies, a larger portal vein diameter was a significant predictor of PVT in patients with cirrhosis without or with splenectomy with OR 1.74 (1.12-2.69) and OR 1.55 (1.26-1.92), respectively. On the other hand, a lower portal vein velocity (PVV) was a significant predictor of PVT in cirrhotics without or with splenectomy with OR 0.93 (0.91-0.96) and OR 0.71 (0.61-0.83), respectively. A PVV of <15 cm/s was the most commonly used cut-off for the prediction of PVT. Patients developing PVT also had a significantly higher splenic length, thickness, and splenic vein velocity. CONCLUSION: The assessment of portal hemodynamic parameters at baseline evaluation in patients with cirrhosis may predict the development of PVT. Further studies are required to determine the optimal cut-offs for various parameters.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Portal Vein / Venous Thrombosis Type of study: Etiology_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limits: Humans Language: En Journal: J Clin Ultrasound Year: 2023 Document type: Article Affiliation country: India Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Portal Vein / Venous Thrombosis Type of study: Etiology_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limits: Humans Language: En Journal: J Clin Ultrasound Year: 2023 Document type: Article Affiliation country: India Country of publication: United States