Natural History and Outcomes of Cavernous Transformation of the Portal Vein in Cirrhosis

被引:3
作者
Attanasi, Michael L. [1 ]
Daher, Halim Bou [1 ]
Rockey, Don C. [1 ]
机构
[1] Med Univ South Carolina, Digest Dis Res Ctr, 96 Jonathan Lucas St,Clin Sci Bldg,Suite 908, Charleston, SC 29425 USA
关键词
Portal hypertension; Vascular; Collateral; Vessel; Cavernoma; Occlusion; SIMPLE NONINVASIVE INDEX; HEPATOCELLULAR-CARCINOMA; SIGNIFICANT FIBROSIS; THROMBOSIS; MANAGEMENT; PREDICT; CT; CLASSIFICATION; HYPERTENSION; DIAGNOSIS;
D O I
10.1007/s10620-023-07993-3
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and AimsCavernous transformation of the portal vein can occur after portal vein thrombosis (PVT). In this study, we investigated clinical complications associated with cavernous transformation in the context of cirrhosis and PVT.MethodsIn this retrospective cohort analysis, 204 patients with cirrhosis and PVT with or without cavernous transformation were identified using MUSC's Clinical Data Warehouse between January 1, 2013, through December 31, 2019. Complete demographic data, clinical history, and laboratory tests were abstracted from the electronic medical record.ResultsOf 204 patients, 41 (20%) had cavernous transformation. MELD, Child-Pugh, and Charlson Comorbidity Index scores were similar among groups. There were no significant differences in the prevalence of esophageal varices (with or without bleeding), splenomegaly, or hepatic encephalopathy in patients with and without cavernous transformation, although ascites tended to be lower in patients with cavernous transformation (31/41 (76%) vs 142/163 (87%), p = 0.06). Patients with cavernous transformation were significantly less likely to have hepatocellular carcinoma (HCC) (13/41 (32%) vs 81/163 (50%), p < 0.05) and had significantly lower APRI (1.4 vs 2.0, p < 0.05) and Fib-4 (4.7 vs 6.5, p < 0.05). Patients with cavernous transformation had lower 5-year mortality (12/41 (29%) vs 81/163 (49%) died, p = 0.06). The 10-year mortality of patients with cavernous transformation without HCC was significantly lower than in those without cavernous transformation (8/28 (29%) vs 46/82 (56%), respectively, p < 0.05).ConclusionsPatients with cavernous transformation appeared to have better outcomes than those without cavernous transformation.
引用
收藏
页码:3458 / 3466
页数:9
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