Download PDF
Z Gastroenterol 2014; 52(10): 1175-1177
DOI: 10.1055/s-0034-1385171
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

Successful Treatment of Partial Portal Vein Thrombosis (PVT) with Low Dose Rivaroxaban

Erfolgreiche Behandlung einer partiellen Pfortaderthrombose mit niedrig dosiertem Rivaroxaban
K. Lenz
1   Internal and Intensive Care Medicine, Konventhospital Barmherzige Brüder, Linz
,
B. Dieplinger
2   Central Laboratory, Konventhospital Barmherzige Brüder, Linz
,
R. Buder
1   Internal and Intensive Care Medicine, Konventhospital Barmherzige Brüder, Linz
,
P. Piringer
1   Internal and Intensive Care Medicine, Konventhospital Barmherzige Brüder, Linz
,
M. Rauch
3   Radiology, Konventhospital Barmherzige Brüder, Linz
,
M. Voglmayr
1   Internal and Intensive Care Medicine, Konventhospital Barmherzige Brüder, Linz
› Author Affiliations
Further Information

Publication History

05 July 2014

08 August 2014

Publication Date:
14 October 2014 (online)

Also available at
    Permissions and Reprints

Abstract

In a 63-year-old cirrhotic patient, recanalisation of a partial portal vein thrombosis was achieved by a low dose of rivaroxaban (10 mg daily). After anticoagulant therapy was stopped, partial vein thrombosis recurred. Restarting rivaroxaban at a dose of 10 mg led to recanalisation. The patient did not suffer any complications; in particular no bleeding occurred during 8 months of treatment.

Zusammenfassung

Bei einer 63-jährigen Patientin mit Leberzirrhose konnte durch Gabe von niedrig dosiertem Rivaroxaban (10 mg täglich p. o.) eine Auflösung einer partiellen Pfortaderthrombose erzielt werden. Nach Beendigung der Antikoagulation kam es zu einem Wiederauftreten der partiellen Pfortaderthrombose. Wiederum konnte durch 10 mg Rivaroxaban täglich nach 2 Monaten die Thrombose aufgelöst werden. Im Rahmen der Antikoagulation mit 10 mg Rivaroxaban täglich über einen Zeitraum von insgesamt 8 Monaten konnten keine Komplikationen, insbesondere keine Blutungen beobachtet werden.

Schlüsselwörter

Pfortaderthrombose - Antikoagulation - Rivaroxaban

Key words

portal vein thrombosis - anticoagulation - rivaroxaban
 

  • References

  • 1 Amitrano L, Guardascione MA, Brancaccio V et al. Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis. J Hepatol 2004; 40: 736-741
    CrossrefPubMedSearch in Google Scholar
  • 2 Rodriguez-Castro KI, Porte RJ, Nadal E et al. Management of nonneoplastic portal vein thrombosis in the setting of liver transplantation: a systematic review. Transplantation 2012; 94: 1145-1153
    PubMedSearch in Google Scholar
  • 3 Seijo S, Garcia-Pagan JC. Anticoagulation in cirrhosis: Ready ....set .... wait!. Hepatology 2013; 58: 1175-1176
    CrossrefPubMedSearch in Google Scholar
  • 4 Duplantier JG, Dubuisson L, Senant N et al. A role for thrombin in liver fibrosis. Gut 2004; 53: 1682-1687
    CrossrefPubMedSearch in Google Scholar
  • 5 Englesbe MJ, Kubus J, Muhammad W et al. Portal vein thrombosis and survival in patients with cirrhosis. Liver Transplantation 2010; 16: 83-90
    CrossrefPubMedSearch in Google Scholar
  • 6 Lisman T, Kamphuisen PW, Northup PG et al. Established and new-generation antithrombotic drugs in patients with cirrhosis – Possibilities and caveats. J Hepatol 2013; 59: 358-366
    CrossrefPubMedSearch in Google Scholar
  • 7 Günther R, Fölsch UR. Pfortaderthrombose bei einem Patienten mit erhöhtem F VIII Spiegel und von Willebrand Faktor. Z Gastroenterol 2002; 40: 409-412
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 Tripodi A, Primignani M, Chantarangkul V et al. An imbalance of pro- vs anti-coagulation factors in plasma from patients with cirrhosis. Gastroenterology 2009; 137: 2105-2111
    CrossrefPubMedSearch in Google Scholar
  • 9 Senzolo M, Sartori M, Rossetto V et al. Prospective evaluation of anticoagulation and transjugular intrahepatic portosistemic shunt for the management of portal vein thrombosis in cirrhosis. Liver Int 2012; 32: 919-927
    CrossrefPubMedSearch in Google Scholar
  • 10 Francoz C, Belghiti J, Vilgrain V et al. Splanchnic vein thrombosis in candidates for liver transplantation: usefulness of screening and anticoagulation. Gut 2005; 54: 69-697
    PubMedSearch in Google Scholar
  • 11 Amitrano L, Guardascione MA, Menchise A et al. Safety and efficacy of anticoagulation therapy with low molecular weight heparin for portal vein thrombosis in patients with liver cirrhosis. J Clin Gastroenterol 2010; 44: 448-451
    PubMedSearch in Google Scholar
  • 12 DeLeve LD, Valla DC, Garcia-Tsao G. Vascular disorders of the liver. Hepatology 2009; 49: 1729-1764
    CrossrefPubMedSearch in Google Scholar
  • 13 Delgado MG, Seijo S, Yepes I et al. Efficacy and safety of anticoagulation on patients with cirrhosis and portal vein thrombosis. Clin Gastroenterol Hepatol 2012; 10: 776-783
    CrossrefPubMedSearch in Google Scholar
  • 14 Kubitza D, Roth A, Becka M et al. Effect of hepatic impairment on the pharmacokinetics and pharmacodynamics of a single dose of rivaroxaban – an oral, direct Factor Xa inhibitor. Br J Clin Pharmacol 2013; 76: 89-98
    CrossrefPubMedSearch in Google Scholar
  • 15 Melissa MartinezM, Tandra A, Vuppalanchi R. Treatment of acute portal vein thrombosis by nontraditional anticoagulation. Hepatology 2014; 60: 425-426
    CrossrefPubMedSearch in Google Scholar
  • 16 Pannach S, Babath J, Beyer-Westendorf J. Successful treatment of acute portal vein thrombosis with rivaroxaban. Thromb Haemost 2013; 110: 626-627
    Thieme ConnectPubMedSearch in Google Scholar
  • 17 Bauer KA. Recent progress in anticoagulant therapy: oral direct inhibitors of thrombin and factor Xa. J Thromb Haemost 2011; (Suppl. 01) 12-19
    PubMedSearch in Google Scholar
  • 18 Weinz C, Schwarz T, Kubitzka D et al. Metabolism and excretion of rivaroxaban, an oral, direct Factor XA inhibitor, in rats, dogs and humans. Drug Metab Dispos 2009; 37: 1056-1064
    CrossrefPubMedSearch in Google Scholar
  • 19 Villa E, Camma C, Marietta M et al. Enoxaparin prevents portal vein thrombosis and liver decompensation in patients with advanced cirrhosis. Gastroenterology 2012; 143: 1253-1260
    CrossrefPubMedSearch in Google Scholar