Abstract Number: PB2255
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » Visceral Vein Thrombosis
Background: Clinical manifestations and optimal management strategies in patients with splanchnic vein thrombosis (SVT) are not well characterized.
Aims: To describe our experience and treatment outcomes in patients with SVT.
Methods: We conducted a retrospective cohort study including all newly diagnosed SVT evaluated at the Thrombosis Clinic of our institution between January 2007 and December 2018. Patient demographics, clinical and treatment information were collected using standardized forms. Efficacy outcome was thrombosis resolution, and safety outcomes included death and occurrence of bleeding. Groups were compared using t-test or Fisher’s exact tests as appropriate.
Results: We included 155 patients (60% males) with a mean age of 56.2 (18-87). Local risk factors were present in 118 (76.1%) patients (secondary SVT), whereas 37 (23.9%) had unknown or only systemic/thrombophilia (primary SVT). Abdominal cancers (31%), surgery (20.6%) and liver cirrhosis (19.4%) were common local risk factors. Thrombophilia screening was conducted in approximately 50% of patients. Factor V Leiden or Prothrombin G20210A mutations were observed in 7.1% of patients whereas 14.4% were JAK2V617F mutation positive. Most common manifestations at onset was abdominal pain (56.1%), whereas incidentally found SVT was 44.6%. Portal vein thrombosis was observed more in primary cases (91.9% vs. 69.5%, p=0.012). Anticoagulation was used in 93.5% cases whereas localized therapy was used only in 5.8%. Indefinite anticoagulation was used more frequently in primary SVT (62.2% vs. 41.5%, p=0.045). Outcomes of treatment in patients with SVT are shown in the table. No statistical difference between patients with and without local risk factors or with or without anticoagulation was observed in either thrombosis resolution, death, or bleeding.
Conclusions: This study suggests that in SVT patients anticoagulation results in partial or complete thrombosis resolution in a significant proportion of patients with an acceptable bleeding risk and that outcomes are similar between patients with or without local risk factors.
Anticoagulation | No Anticoagulation | Primary SVT | Secondary SVT | |
Thrombosis status | ||||
Complete resolution | 37% | 29% | 30% | 38% |
Partial resolution | 26% | – | 18% | 27% |
Unchanged | 31% | 71% | 46% | 29% |
Worsening | 6% | – | 6% | 6% |
Major Bleeding | 6% | 10% | 8% | 6% |
Any Bleeding | 10% | 30% | 8% | 12% |
Death | 13% | 20% | 3% | 17% |
[Outcomes of treatment in patients with SVT.]
To cite this abstract in AMA style:
Kawata (Iida) E, Siew D-, Payne J, Xenocostas A, Louzada M, Kovacs M, Lazo-Langner A. A Retrospective Cohort Study on Splanchnic Vein Thrombosis [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/a-retrospective-cohort-study-on-splanchnic-vein-thrombosis/. Accessed March 21, 2024.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/a-retrospective-cohort-study-on-splanchnic-vein-thrombosis/