Outcomes of Portal Vein Tumour Thrombosis [PVTT] with Or Without Anticoagulation In 13 Patients Following in Vascular Department, Ttsh, Singapore

1.1. Aim: To look at the clinical outcomes in portal vein tumour thrombosis [PVTT] with or without anticoagulation. 1.2. Method: This study was approved by ethics committee. Patients following up in Vascular department were recruited with retrospective analysis from 2011 to 2016. Patients were classified into 3 groups: Portal vein thrombosis [PVT] with cirrhosis, malignancy, and infections. The biggest group was PVT with malignancy also known as portal vein tumour thrombosis [PVTT]. This group was analysed in this study. Statistical analysis was done with frequency, means, and percentages were calculated. Outcome measures were defined as clot resolution with or without anticoagulation, bleeding, recurrence, death. 1.3. Results: Out of 30 patients of PVT, 13 patients of PVTT were analysed in this study. They were primary hepatocellular carcinoma [HCC] in 4 and secondary HCC in 9 patients. Mean age was 66.8 years [range of 47-91 years]. There were 6 [46.2%] males and 7 [53.8%] females with ethnicity Chinese in 11 [84.6%], 2 [6.7%] Malay, other races 1 [7.7%]. Six patients received anticoagulation and 7 did not receive anticoagulation. 1.Of 6 patients who received anticoagulation, there was complete resolution of thrombus in 1 [16.7%], partial resolution in 0 [0.0%], no resolution in 5 [83.3%]. There was bleeding in 1 [16.7%], there was no recurrence and 4 [66.7%] died during the period of follow-up. 2.Of 7 patients who did not receive anticoagulation, there was complete resolution of thrombus in 0 [0.0%], partial resolution in 0 [0.0%], no resolution in 7 [100%]. There was bleeding in 0 [0.0%], there was recurrence in 0 [0.0%] and 4 [57.1%] died during the period of follow-up 1.4. Conclusion: Anticoagulation is of marginal benefit in terms of mortality in patient with PVTT. The rate of recurrence is similar in patients with or without anticoagulation, however, PVTT patients with anticoagulation is associated with increased risk of bleeding.