RESUMO
Background and Aim: Portal vein thrombosis (PVT) is particularly detected in advanced liver cirrhosis patients. We aimed to analyze the risk factors for PVT in liver transplant candidates. Materials and Methods: Dataset for consecutive 165 cirrhotic patients who were evaluated for liver transplantation (LT) were retrospectively analyzed. We sorted patients into two groups: patients with PVT and patients without PVT. Included variables were age, sex, etiology of liver disease, body mass index, MELD-Na score, Child-Pugh score, clinical variables reflecting portal hypertension, and hepatocellular carcinoma. Univariate and multivariate logistic regression analyses were used to identify risk factors of PVT. Results: Of 165 LT candidates, 46 had PVT (27.9%). Ascites, thrombocytopenia, history of variceal bleeding, and band ligation were risk factors for PVT in univariate analysis. In multivariate analysis, only a history of variceal bleeding (OR 3.45, 95% CI 1.02-11.6, p=0.046) significantly increased the risk of PVT. Conclusion: The previous history of variceal bleeding predicts PVT development in cirrhosis, suggesting that the severity of portal hypertension is a major predictive factor for PVT in patients with cirrhosis. Future prospective studies are needed to risk stratifying cirrhosis patients prior to LT for future PVT development and to define the prophylactic role of anticoagulation in these patients.
RESUMO
BACKGROUND: We report our initial experience with the CatchView (CV) thrombectomy device in patients with acute ischemic stroke (AIS). METHODS: A retrospective analysis of 53 of 284 AIS patients (mean age 66.6±14.8 years, range 37-94) treated with a CV device between January 2019 and February 2020 was performed. The baseline characteristics (gender, age, comorbidities, National Institutes of Health Stroke Scale (NIHSS) score, intravenous tissue plasminogen activator (IV-tPA) administration, and occlusion localization) of these subjects were recorded. Modified Thrombolysis in Cerebral Ischemia (mTICI) scores of 2b and 3 were considered to indicate successful recanalization, and subjects with a modified Rankin Scale score of ≤2 on day 90 was considered a good clinical outcomes. RESULTS: The mean NIHSS score was 12.3±3. Successful recanalization was achieved in 45 subjects (84.90%), and the rate of good clinical outcomes on day 90 was 43.39%. The secondary distal embolus rate was 5.66%. Symptomatic hemorrhage was observed in 3.77% of the subjects, and the mortality rate was 13.2%. CONCLUSIONS: Mechanical thrombectomy devices include a wide array of endovascular tools for removing clots in AIS patients. In terms of successful recanalization and good clinical outcomes on day 90, our initial experience with the CV devices was encouraging.
