Portal Vein Thrombosis

Foreword
Preface
Acknowledgments
Contents
1: Anatomy of Portal Vein System
	1.1	 Introduction
	1.2	 Embryology of the Portal Vein System
	1.3	 Gross Anatomy
	1.4	 Tributaries
		1.4.1	 Portal Vein
		1.4.2	 Superior Mesenteric Vein
		1.4.3	 Splenic Vein
		1.4.4	 Inferior Mesenteric Vein
	1.5	 Normal Portosystemic Anastomoses
	1.6	 Portosystemic Collateral Pathways
	1.7	 Anatomical Variants of Portal Vein
		1.7.1	 Clinical Significance
		1.7.2	 Liver Transplantation
		1.7.3	 Transjugular Intrahepatic Portosystemic Shunt
		1.7.4	 Portal Vein Embolization (PVE)
		1.7.5	 Liver Resection
	1.8	 Congenital Anomalies
		1.8.1	 Congenital Agenesis of the PV
		1.8.2	 Congenital Intrahepatic Portosystemic Shunt
		1.8.3	 Congenital Arterio-Portal Shunt
		1.8.4	 Portal Vein Aneurysm
	1.9	 Topographical Variants
		1.9.1	 Preduodenal Portal Vein
		1.9.2	 Circumportal Pancreas
	1.10	 Conclusion
	References
2: Epidemiology of Portal Vein Thrombosis
	2.1	 Portal Vein Thrombosis (Non-cirrhotic)
	2.2	 Portal Vein Thrombosis (Cirrhotic)
	References
3: Risk Factors for Portal Vein Thrombosis
	3.1	 Risk Factors for PVT in Patients with Liver Disease
		3.1.1	 Etiology of Liver Disease
		3.1.2	 Ascites and Diuretic Treatment
		3.1.3	 Esophageal Varices
		3.1.4	 Inherited Hypercoagulable States
		3.1.5	 Acquired Hypercoagulable States
		3.1.6	 Hepatocellular Carcinoma
		3.1.7	 Metabolic Diseases
		3.1.8	 Splenectomy
		3.1.9	 Helicobacter pylori Infection and Gut Microbiota
		3.1.10	 Alterations in Hemostasis in End-Stage Liver Disease
	3.2	 Risk Factors of PVT in Patients without Liver Disease
		3.2.1	 Abdominal Surgery
		3.2.2	 Radiologic Interventions
		3.2.3	 Intraabdominal Infection and Inflammation
		3.2.4	 Inherited Hypercoagulable States
		3.2.5	 Acquired Hypercoagulable States
		3.2.6	 Malignancies
	3.3	 Conclusion
	References
4: Imaging of Portal Vein Thrombosis
	4.1	 Introduction
	4.2	 Etiology and Pathophysiology
	4.3	 Role of Imaging
		4.3.1	 Acute Portal Vein Thrombosis
			4.3.1.1	 Ultrasonography
			4.3.1.2	 Computed Tomography (CT)
			4.3.1.3	 Magnetic Resonance Imaging
			4.3.1.4	 Angiography
		4.3.2	 Chronic Portal Vein Thrombosis
			4.3.2.1	 Ultrasonography
			4.3.2.2	 Computed Tomography
			4.3.2.3	 Magnetic Resonance Imaging
		4.3.3	 Specific Types of Portal Vein Thrombosis
			4.3.3.1	 Septic Thrombophlebitis
			4.3.3.2	 Malignant Portal Vein Thrombosis
	4.4	 Conclusion
	References
5: Classification of Non-malignant Portal Vein Thrombosis
	5.1	 Introduction
	5.2	 Classification Systems for PVT
		5.2.1	 Stieber Classification (1991)
		5.2.2	 Nonami Classification (1992)
		5.2.3	 Gayowski et al. (1996)
		5.2.4	 Yerdel Classification (2000)
		5.2.5	 Jamieson Classification (2000)
		5.2.6	 Charco et al. (2005)
		5.2.7	 Bauer et al. (2006)
		5.2.8	 Ma et al. (2014)
		5.2.9	 Sarin et al. (2016)
	5.3	 Conclusion
	References
6: Impact of Non-malignant Portal Vein Thrombosis on Outcomes of Liver Cirrhosis
	6.1	 Impact of Portal Vein Thrombosis on Liver Decompensation and Prognosis
	6.2	 Impact of PVT on Liver Cirrhosis-Related Complications
	6.3	 Impact of PVT on Liver Transplantation
	6.4	 Effect of PVT Therapy on Liver Cirrhosis
	6.5	 Conclusions
	References
7: Anticoagulation for Nontumoral Portal Vein Thrombosis
	7.1	 Introduction
	7.2	 Clinical Reality of Anticoagulation in Patients With and Without Cirrhosis
		7.2.1	 Noncirrhotic Nontumoral PVT
		7.2.2	 Cirrhotic Nontumoral PVT
	7.3	 Indications for Anticoagulation in Nontumoral Portal Vein Thrombosis
		7.3.1	 Noncirrhotic Nontumoral PVT
		7.3.2	 Cirrhotic Nontumoral PVT
	7.4	 Safety of Anticoagulation in Patients With and Without Cirrhosis and Nontumoral PVT
		7.4.1	 Noncirrhotic Nontumoral PVT
		7.4.2	 Cirrhotic Nontumoral PVT
	7.5	 Choice of Anticoagulant, Doses and Duration of Anticoagulation
		7.5.1	 Noncirrhotic Nontumoral PVT
		7.5.2	 Cirrhotic Nontumoral PVT
	7.6	 Efficacy of Anticoagulation on Recanalization of Nontumoral Portal Vein Thrombosis and Clinical Significance
		7.6.1	 Noncirrhotic Nontumoral PVT
		7.6.2	 Cirrhotic Nontumoral PVT
	7.7	 Thrombosis Recurrence After Stopping Anticoagulation
		7.7.1	 Noncirrhotic Nontumoral PVT
		7.7.2	 Cirrhotic Nontumoral PVT
	7.8	 Anticoagulant Therapy and Prognosis in Nontumoral PVT in Patients With and Without Cirrhosis
		7.8.1	 Noncirrhotic Nontumoral PVT
		7.8.2	 Cirrhotic Nontumoral PVT
	References
8: Thrombolysis for Non-malignant Portal Vein Thrombosis
	8.1	 Introduction
		8.1.1	 Epidemiology
		8.1.2	 Pathophysiology and Etiology
		8.1.3	 Clinical Presentation
		8.1.4	 Diagnosis of PVT
		8.1.5	 Management
	8.2	 Thrombolysis
		8.2.1	 Contraindications
		8.2.2	 Treatment Protocols
		8.2.3	 Systemic Thrombolysis
		8.2.4	 Catheter Directed Local Thrombolysis
		8.2.5	 Follow Up During Treatment
		8.2.6	 Acute and Chronic Complications
		8.2.7	 Long Term Prognosis
		8.2.8	 Further Imaging and Medical Follow Up
	References
9: Transjugular Intrahepatic Portosystemic Shunt for Non-malignant Portal Vein Thrombosis
	9.1	 Introduction
	9.2	 Epidemiology
	9.3	 Natural History and Prognosis
	9.4	 Diagnostic Evaluation
	9.5	 TIPS as a Therapeutic Option for Non-malignant PVT
		9.5.1	 TIPS Technique
		9.5.2	 TIPS for Acute Non-cirrhotic PVT
		9.5.3	 TIPS for Chronic Non-cirrhotic PVT
		9.5.4	 TIPS for Cirrhotic PVT
		9.5.5	 TIPS for Cirrhosis Complications
		9.5.6	 TIPS Procedure-Related Complications
	9.6	 Role of Anticoagulants Post-TIPS for PVT
	9.7	 Limitations of the Existing Data and Future Research
	9.8	 Conclusion
	References
10: Liver Transplantation in the Setting of Non-malignant Portal Vein Thrombosis
	10.1	 Introduction
	10.2	 Portal Vein Thrombosis in Candidates for Transplantation
	10.3	 Diagnosis and Classification of Portal/Splanchnic Vein Thrombosis
	10.4	 Impact of Portal Vein Thrombosis on Pre-transplant Mortality: Is Priority Justified?
	10.5	 Management of Portal Vein Thrombosis in Candidates for Transplantation
		10.5.1	 Anticoagulation
		10.5.2	 Transjugular Intrahepatic Portosystemic Shunt (TIPS)
	10.6	 Transplantation Procedure in Patients with Portal Vein Thrombosis
		10.6.1	 Partial Portal Vein Thrombosis
		10.6.2	 Complete Thrombosis Limited to the Portal Vein
		10.6.3	 Diffuse Thrombosis of the Portal and Mesenteric Veins
		10.6.4	 Portal Vein Thrombosis in the Context of Living Donor Liver Transplantation
	10.7	 Impact of Portal Vein Thrombosis on Post-transplant Outcomes
	10.8	 Post-transplant Re-thrombosis: Prevention and Screening
	10.9	 Conclusions and Perspectives
	References
11: Management of Portal Vein Thrombosis in Liver Cancer
	11.1	 Surgical Resection
	11.2	 Systemic and Locoregional Treatments
	References
12: Future Directions
	12.1	 Risk Factors for PVT
	12.2	 PVT Treatment and Prophylaxis
	12.3	 Conclusion
	References