Management of Splanchnic Venous Thrombosis: An Update

Area of Science:

• Vascular Medicine
• Hematology
• Gastroenterology

Background:

• Splanchnic venous thrombosis (SVT) is a rare but serious condition affecting visceral veins.
• Current management guidelines require updates based on recent evidence.

Purpose of the Study:

• To provide a comprehensive review of SVT diagnosis and management.
• To critically appraise recent advances in anticoagulant therapy, prognosis, and clinical decision-making.

Main Methods:

• Review of prospective studies, meta-analyses, and registry data.
• Focus on evidence for anticoagulant therapy in diverse SVT settings.

Main Results:

• Anticoagulation improves vessel recanalization and survival in cirrhotic portal vein thrombosis (PVT).
• Direct oral anticoagulants (DOACs) demonstrate comparable or superior efficacy and safety to conventional anticoagulants.
• Low-dose rivaroxaban is effective for secondary prevention in chronic non-cirrhotic PVT.
• Anticoagulation reduces recurrence in cancer-associated SVT and shows promise in Budd-Chiari syndrome.

Conclusions:

• DOACs represent a significant advancement in SVT management.
• Further randomized trials, pediatric data, and long-term secondary prevention studies are essential for standardizing care.