Background: Splanchnic vein thrombosis (SVT) is an unusual site of venous thromboembolism. Screening for inherited thrombophilias, as part of the etiological assessment of these thrombotic events, as well as its impact on anticoagulant therapy duration are nuanced and controversial.
Aims: This study aimed to evaluate the impact of thrombophilia testing in both clinical and therapeutic management of SVT.
Methods: This was a retrospective study, including 90 patients followed for SVT from January 2008 to December 2020. Thrombosis associated with an hepatocellular carcinoma were not included. Clinical characteristics of patients, data on thrombotic events and results from thrombophilia screening were recorded.
Results: The mean age was 50 years old. 54 patients were women (60%). Portal vein was the most frequent localization (84,5%). Underlying diseases were cirrhosis in 42 patients (46,7%), myeloproliferative neoplasms in 9 patients (10%), inflammatory bowel disease in 5 patients (5,56%) and other aetiologies in 34 patients (37,74%). A thrombophilia testing was performed in 61 patients (67.8%). The decision to screen for thrombophilia was significantly associated to young age (75,51% vs 24,49%). Combined deficiencies were found in 34 patients due to liver failure (n=20) or antivitamin K treatment (n=9). A heriditary deficiency of coagulation inhibitors was documented in 5 patients. Thrombophilia abnormalities had no significant impact on the decision to start or not anticoagulation. However, other factors such as complete obstruction (89,19% vs 10,81%), recent thrombosis (86,84% vs 13,16%) and low bleeding risk (82,19% vs 17,8%) were significantly associated to the decision to start anticoagulation. Besides, both the absence of underlying liver disease (75% vs 25%) and the absence of vein recanalization (85,71% vs 14,29%) were significantly related to an indefinite treatment.
Conclusions: Thrombophilia testing was often performed in young patients with SVT but the results did not influence therapeutic management. Duration of anticoagulation therapy was rather associated to underlying disease and thrombus characteristics.
To cite this abstract in AMA style:Rouached R, Baccouche H, Laabidi A, Kechir H, Boubaker J, Laamari N, Ben Romdhane N. Impact of Thrombophilia Testing in Splanchnic Vein Thrombosis Management [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/impact-of-thrombophilia-testing-in-splanchnic-vein-thrombosis-management/. Accessed September 16, 2021.
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