Search results for "Portal vein thrombosi"
showing 10 items of 32 documents
Transarterial chemoembolization and sorafenib in patients with intermediate-stage hepatocellular carcinoma: time to enter routine clinical practice?
2015
According to the guidelines of the European Association for the Study of the Liver (EASL), patients affected from hepatocellular carcinoma (HCC) can be classified according to the Barcelona Clinic Liver Cancer (BCLC) staging system. This classification system divides HCC patients in five stages (0, A, B, C and D) on the basis of a number of prognostic and treatment- related variables such as tumor status and liver function. A specific treat ment approach is then proposed for each of the above-mentioned stages. Transarterial chemoembolization (TACE) is recommended as first-line therapy in the treatment of patients with intermediate-stage (BCLC-B class) HCC [1]. The efficacy of this procedure…
Survival of patients with hepatocellular carcinoma in cirrhosis: a comparison of BCLC, CLIP and GRETCH staging systems
2008
Summary Background A major problem in assessing the likelihood of survival of patients with hepatocellular carcinoma (HCC) arises from a lack of models capable of predicting outcome accurately. Aim To compare the ability of the Italian score (CLIP), the French classification (GRETCH) and the Barcelona (BCLC) staging system in predicting survival in patients with HCC. Methods We included 406 consecutive patients with cirrhosis and HCC. Seventy-eight per cent of patients had hepatitis C. Independent predictors of survival were identified using the Cox model. Results One-hundred and seventy-eight patients were treated, while 228 were untreated. The observed mortality was 60.1% in treated p…
Enoxaparin Prevents Portal Vein Thrombosis and Liver Decompensation in Patients With Advanced Cirrhosis
2012
BACKGROUND & AIMS: We performed a randomized controlled trial to evaluate the safety and efficacy of enoxaparin, a low-molecular-weight heparin, in preventing portal vein thrombosis (PVT) in patients with advanced cirrhosis. METHODS: In a nonblinded, single-center study, 70 outpatients with cirrhosis (Child-Pugh classes B7-C10) with demonstrated patent portal veins and without hepatocellular carcinoma were assigned randomly to groups that were given enoxaparin (4000 IU/day, subcutaneously for 48 weeks; n = 34) or no treatment (controls, n = 36). Ultrasonography (every 3 months) and computed tomography (every 6 months) were performed to check the portal vein axis. The primary outcome was pre…
The Clinical Course of Portal Hypertension in Liver Cirrhosis
2000
Portal hypertension is caused by liver cirrhosis in almost %% of patients in Europe and in North America. Other causes such as hepato-splenic schistosomiasis, noncirrhotic portal fibrosis and extrahepatic portal vein thrombosis are more common in Asia and South America.
Computed Tomography of HCC
2016
Contrast-enhanced CT allows an accurate noninvasive diagnosis of Hepatocellular Carcinoma (HCC) nodules, and assessment of hepatic vascular anatomy and patency. The use of state-of-the-art equipment and of a tailored protocol is crucial. CT results help to detect and stage HCC, select the best treatment option, and evaluate response to therapy. In this chapter, the CT protocol for the cirrhotic liver, the CT features of HCC before and after treatment and of portal vein thrombosis will be described.
Transarterielle Chemoembolisation (TACE) des Hepatozellulären Karzinoms (HCC) bei Patienten mit Pfortaderthrombose - Erfahrungen
2007
PURPOSE: Comparative analysis of the course of disease in patients with initial diagnosis of portal vein thrombosis in HCC treated with sequential TACE. Evaluation of the efficacy and safety of the method in a selected patient cohort. PATIENTS AND METHODS: The study included 22 patients with HCC that were palliatively treated at least 3 times with TACE. All patients presented a portal vein thrombosis in the initial CT investigation. The TACE-procedure was carried out in regular intervals using a suspension consisting of a fixed dosage of Mitomycin C (10 mg) and 10-20 ml Lipiodol. Follow-up investigations were carried out with contrast enhanced Multislice-CT before and after TACE and control…
Sequentielle transarterielle Chemoembolisation (TACE) des hepatozellulären Karzinoms (HCC) - Erfahrungsbericht eines einzelnen Zentrums über 5 Jahre
2007
PURPOSE: To analyze the course of disease of patients treated with sequential TACE and to evaluate the dependent and independent prognostic factors for patient survival using the Cox Proportional Hazard Model. MATERIALS AND METHODS: 94 patients palliatively treated with TACE. Patients were selected if they had been treated at least 3 times. The TACE procedure was carried out at 8-week intervals using a suspension consisting of a fixed dosage of Mitomycin C (10 mg) and 10 ml Lipiodol. Follow-up investigations included contrast-enhanced multislice CT before and after TACE and assessment of the laboratory test results (i. e., blood count, liver enzymes, and coagulation). RESULTS: In 66.7 % of …
The role of portal vein thrombosis in the clinical course of inflammatory bowel diseases: report on three cases and review of the literature.
2012
Inflammatory bowel diseases are associated with an increased risk of vascular complications. The most important are arterial and venous thromboembolisms, which are considered as specific extraintestinal manifestations of inflammatory bowel diseases. Among venous thromboembolism events, portal vein thrombosis has been described in inflammatory bowel diseases. We report three cases of portal vein thrombosis occurring in patients with active inflammatory bowel disease. In two of them, hepatic abscess was present. Furthermore, we performed a systematic review based on the clinical literature published on this topic.
Hyperhomocysteinemia and the methylene tetrahydrofolate reductase C677T mutation in splanchnic vein thrombosis
2010
Introduction: The role that hyperhomocysteinemia (HH) and the C677T mutation in 5,10-methylenetetrahydrofolate reductase (MTHFR) play in splanchnic vein thrombosis (SVT) remains unclear due to this unusual thrombotic location. Objective: To analyse the possible association of HH with the C677T mutation in the MTHFR gene in SVT. Material and methods: We determined homocysteine levels and the C677T MTHFR mutation, along with classical cardiovascular risk factors, in 48 patients with SVT (18 Budd-Chiari syndrome, 11 mesenteric vein thrombosis, 19 portal vein thrombosis) and 84 controls. Results: In the univariate analysis, patients with SVT showed statistically higher homocysteine levels (P = …
Radiologic Evaluation of the Transplant Candidate
2003
Before a patient is placed on the waiting list for liver transplantation, a variety of screening procedures are performed, including laboratory tests and radiological procedures. One goal is to search for abnormalities that preclude liver transplantation. Another is to detect abnormalities that in some way will affect the operative procedure. The individual periopera- tive risk is evaluated by searching for pulmonary, cardiac, and renal changes.