Background and Aim: Portal Vein Thrombosis (PVT) is a well known risk of liver cirrhosis (LC) despite the longer coagulation times. Patients with advanced liver disease have an increase risk of bleeding because of coagulopathy and portal hypertension. The aim of our study was to assess the efficacy and safety of low dosage of fondaparinux in patients with advanced LC and with PVT. Methods: We screened for hepatocellular carcinoma 26 cirrhotic patients by ultrasound doppler. Twelve patients presented PVT without hepatocellular carcinoma. Three patients with portal cavernoma were excluded from the study. Only six patients with recent PVT entered the study and, after informed consent, received 5 mg/day of fondaparinux subcutaneously for at least four months. An endoscopic examination and Computed Tomography (CT) was performed in all the patients. A follow up by ultrasound with doppler examination was done every month while CT was done at fourth month. Results: The etiology of cirrhosis was: HCV infection in three patients, HBV in two and alcoholic in one. four patients were in class A Child Pugh and two in class B. Four patients presented class F1/F2 esophageal varices, two patients with F3 class and the evidence of red cherry spot were previous submitted to band ligation. PVT was occludent in one patients and incomplete in five patients. Extension to portal branches was noted in two patients while extension to splenic and superior mesenteric vein was disclosed respectively in two and one patients. Complete recanalization of PVT occurred in four patients (4/6= 66%) (one of whom with a total PVT), while partial recanalization was seen in two patients (33%). No significant side effects were noted in all the patients. Conclusion: In cirrhotic patients without hepatocellular carcinoma and with PVT anti-thromboembolic therapy with low dosage of fondaparinux (5mg/day subcutaneously) seems to be safe and effective as treatment. Further studies,on more patients, will be needed to confirm our results.
|Titolo:||SAFETY AND EFFICACY OF LOW DOSAGE OF FONDAPARINUX IN CIRRHOTIC PATIENTS WITH PORTAL VEIN THROMBOSIS|
|Data di pubblicazione:||2010|
|Citazione:||SAFETY AND EFFICACY OF LOW DOSAGE OF FONDAPARINUX IN CIRRHOTIC PATIENTS WITH PORTAL VEIN THROMBOSIS / BERTINO G; ARDIRI A; CAMPAGNA D; CALVAGNO GS. - In: INTERNAL AND EMERGENCY MEDICINE. - ISSN 1828-0447. - 5:supplement 2(2010), pp. S155-S155. ((Intervento presentato al convegno 111th National Congress of the Italian Society of Internal Medicine tenutosi a Roma nel 16-19 Ottobre 2010.|
|Appare nelle tipologie:||4.3 Poster|