Prognostic factors and treatment outcome in mesenteric vein thrombosis

Nasim Hedayati, Gordon M. Riha, Panagiotis Kougias, Tam T. Huynh, Charlie Cheng, Carlos Bechara, Jean Bismuth, Alan Dardik, Peter H. Lin

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Mesenteric vein thrombosis (MVT) can result in intestinal ischemia and is associated with high morbidity and mortality due in part to its frequent delay in diagnosis. The purpose of this study was to evaluate clinical presentation, diagnostic evaluation, and treatment outcome of MVT. Methods: Hospital records and clinical data of all patients treated for MVT were reviewed during a recent 14-year period. Clinical outcome and factors affecting survival were analyzed. Results: A total of 68 patients were included in the study. Abdominal exploration was performed in 23 patients (34%), and second-look operation was necessary in 18 patients (26%). Three patients (4%) underwent unsuccessful operative mesenteric vein thrombectomy, whereas percutaneous transhepatic mesenteric thrombectomy was performed successfully in 3 patients (4%). The 30-day mortality rate was 20%. Forty-six of the 54 survivors were treated with long-term oral anticoagulation therapy. Actuarial survival at 2, 4, 6, and 10 years was 68%, 57%, 43%, and 22%, respectively. Risk factor analysis showed malignancy (P <.002), age >60 years (P <.005), cirrhosis (P <.02), symptom duration (P <.005), and bowel resection (P <.03) were associated with mortality. Logistic regression analysis showed age >60 years (odds ratio [OR], 3.64; P =.03), malignancy (OR, 3.88; P =.02), and prolonged symptom duration (OR, 5.62; P =.01) were independent predictors of mortality. Conclusions: MVT is associated with significant mortality. Prompt diagnostic evaluation with computed tomography may reduce potential treatment delay. Underlying malignancy, advanced age, and prolonged symptom duration are predictive of poor outcome.

Original languageEnglish (US)
Pages (from-to)217-224
Number of pages8
JournalVascular and Endovascular Surgery
Volume42
Issue number3
DOIs
StatePublished - Jun 2008
Externally publishedYes

Fingerprint

Mesenteric Veins
Thrombosis
Thrombectomy
Mortality
Odds Ratio
Neoplasms
Survival
Hospital Records
Statistical Factor Analysis
Survivors
Ischemia
Tomography
Morbidity
Therapeutics

Keywords

  • Clinical outcome
  • Intestinal ischemia
  • Mesenteric vein thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hedayati, N., Riha, G. M., Kougias, P., Huynh, T. T., Cheng, C., Bechara, C., ... Lin, P. H. (2008). Prognostic factors and treatment outcome in mesenteric vein thrombosis. Vascular and Endovascular Surgery, 42(3), 217-224. https://doi.org/10.1177/1538574407312653

Prognostic factors and treatment outcome in mesenteric vein thrombosis. / Hedayati, Nasim; Riha, Gordon M.; Kougias, Panagiotis; Huynh, Tam T.; Cheng, Charlie; Bechara, Carlos; Bismuth, Jean; Dardik, Alan; Lin, Peter H.

In: Vascular and Endovascular Surgery, Vol. 42, No. 3, 06.2008, p. 217-224.

Research output: Contribution to journalArticle

Hedayati, N, Riha, GM, Kougias, P, Huynh, TT, Cheng, C, Bechara, C, Bismuth, J, Dardik, A & Lin, PH 2008, 'Prognostic factors and treatment outcome in mesenteric vein thrombosis', Vascular and Endovascular Surgery, vol. 42, no. 3, pp. 217-224. https://doi.org/10.1177/1538574407312653
Hedayati N, Riha GM, Kougias P, Huynh TT, Cheng C, Bechara C et al. Prognostic factors and treatment outcome in mesenteric vein thrombosis. Vascular and Endovascular Surgery. 2008 Jun;42(3):217-224. https://doi.org/10.1177/1538574407312653
Hedayati, Nasim ; Riha, Gordon M. ; Kougias, Panagiotis ; Huynh, Tam T. ; Cheng, Charlie ; Bechara, Carlos ; Bismuth, Jean ; Dardik, Alan ; Lin, Peter H. / Prognostic factors and treatment outcome in mesenteric vein thrombosis. In: Vascular and Endovascular Surgery. 2008 ; Vol. 42, No. 3. pp. 217-224.
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AU - Riha, Gordon M.

AU - Kougias, Panagiotis

AU - Huynh, Tam T.

AU - Cheng, Charlie

AU - Bechara, Carlos

AU - Bismuth, Jean

AU - Dardik, Alan

AU - Lin, Peter H.

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N2 - Background: Mesenteric vein thrombosis (MVT) can result in intestinal ischemia and is associated with high morbidity and mortality due in part to its frequent delay in diagnosis. The purpose of this study was to evaluate clinical presentation, diagnostic evaluation, and treatment outcome of MVT. Methods: Hospital records and clinical data of all patients treated for MVT were reviewed during a recent 14-year period. Clinical outcome and factors affecting survival were analyzed. Results: A total of 68 patients were included in the study. Abdominal exploration was performed in 23 patients (34%), and second-look operation was necessary in 18 patients (26%). Three patients (4%) underwent unsuccessful operative mesenteric vein thrombectomy, whereas percutaneous transhepatic mesenteric thrombectomy was performed successfully in 3 patients (4%). The 30-day mortality rate was 20%. Forty-six of the 54 survivors were treated with long-term oral anticoagulation therapy. Actuarial survival at 2, 4, 6, and 10 years was 68%, 57%, 43%, and 22%, respectively. Risk factor analysis showed malignancy (P <.002), age >60 years (P <.005), cirrhosis (P <.02), symptom duration (P <.005), and bowel resection (P <.03) were associated with mortality. Logistic regression analysis showed age >60 years (odds ratio [OR], 3.64; P =.03), malignancy (OR, 3.88; P =.02), and prolonged symptom duration (OR, 5.62; P =.01) were independent predictors of mortality. Conclusions: MVT is associated with significant mortality. Prompt diagnostic evaluation with computed tomography may reduce potential treatment delay. Underlying malignancy, advanced age, and prolonged symptom duration are predictive of poor outcome.

AB - Background: Mesenteric vein thrombosis (MVT) can result in intestinal ischemia and is associated with high morbidity and mortality due in part to its frequent delay in diagnosis. The purpose of this study was to evaluate clinical presentation, diagnostic evaluation, and treatment outcome of MVT. Methods: Hospital records and clinical data of all patients treated for MVT were reviewed during a recent 14-year period. Clinical outcome and factors affecting survival were analyzed. Results: A total of 68 patients were included in the study. Abdominal exploration was performed in 23 patients (34%), and second-look operation was necessary in 18 patients (26%). Three patients (4%) underwent unsuccessful operative mesenteric vein thrombectomy, whereas percutaneous transhepatic mesenteric thrombectomy was performed successfully in 3 patients (4%). The 30-day mortality rate was 20%. Forty-six of the 54 survivors were treated with long-term oral anticoagulation therapy. Actuarial survival at 2, 4, 6, and 10 years was 68%, 57%, 43%, and 22%, respectively. Risk factor analysis showed malignancy (P <.002), age >60 years (P <.005), cirrhosis (P <.02), symptom duration (P <.005), and bowel resection (P <.03) were associated with mortality. Logistic regression analysis showed age >60 years (odds ratio [OR], 3.64; P =.03), malignancy (OR, 3.88; P =.02), and prolonged symptom duration (OR, 5.62; P =.01) were independent predictors of mortality. Conclusions: MVT is associated with significant mortality. Prompt diagnostic evaluation with computed tomography may reduce potential treatment delay. Underlying malignancy, advanced age, and prolonged symptom duration are predictive of poor outcome.

KW - Clinical outcome

KW - Intestinal ischemia

KW - Mesenteric vein thrombosis

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