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- W3208291285 abstract "Purpose: We report the outcome of isolated splenic vein thrombosis management from tertiary referral HPB units including impact of anti-coagulation on recanalization rates and subsequent variceal bleeding risk. Methods: A retrospective cohort study including all patients diagnosed with iSVT on CT scan abdomen and pelvis between 2011 and 2019 from two institutions. Patients with both SVT and portal vein thrombosis at diagnosis, and isolated splenic vein thrombosis secondary to cancer were excluded. Response to anti-coagulation, recanalization rates, risk of bleeding and progression to portal vein thrombosis were examined. Results: Ninety-eight patients with iSVT were included of which thirty-nine patients received anti-coagulation (40%). The most common cause of iSVT was acute pancreatitis n=88 (90%). The recanalization rate in the anticoagulation group was 46% vs 15% in patients receiving no anticoagulation (p=0.0008, OR = 4.7, 95% CI 1.775 to 11.72). Upper abdominal vascular collaterals (demonstrated on CT scan angiography) was significantly less among patients who received anticoagulation treatment (p = 0.03, OR = 0.4, 95% CI 0.1736 to 0.9288). The overall rate of upper GI variceal related bleeding was 3% (n=3/98) and it was independent of anticoagulation treatment, two patients received therapeutic anticoagulation. Conclusion: The current data supports that therapeutic anti-coagulation is associated with a statistically significant increase in recanalization rates of the splenic vein; with a subsequent reduction in radiological left sided portal hypertension, with a very low risk of bleeding from varices. The findings from this retrospective study should be confirmed in a randomised clinical trial." @default.
- W3208291285 created "2021-11-08" @default.
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- W3208291285 date "2021-01-01" @default.
- W3208291285 modified "2023-10-18" @default.
- W3208291285 title "Management of isolated splenic vein thrombosis: risks and benefits of anticoagulation" @default.
- W3208291285 doi "https://doi.org/10.1016/j.hpb.2021.08.638" @default.
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