Estadísticas

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    "titulo" => "Tratamiento de la trombosis portal no tumoral en la cirrosis"
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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La trombosis portal en la cirrosis es una complicaci&#243;n relativamente frecuente asociada a la presencia de un fenotipo protromb&#243;tico acompa&#241;ante de la enfermedad hep&#225;tica avanzada&#46; Las consecuencias de la trombosis portal son relevantes porque se puede asociar a deterioro de la funci&#243;n hep&#225;tica&#44; puede contraindicar la realizaci&#243;n de trasplante hep&#225;tico y aumentar la morbilidad en torno al procedimiento quir&#250;rgico&#46; Existe controversia acerca del tratamiento m&#225;s eficaz de la trombosis portal que adem&#225;s se sustenta en informaci&#243;n poco robusta y cuyo objetivo primario es obtener la repermeabilizaci&#243;n del vaso&#46; Diversos estudios sugieren que la anticoagulaci&#243;n instaurada precozmente se asocia a repermeabilizaci&#243;n portal de forma m&#225;s frecuente que la ausencia de tratamiento&#44; con una tasa baja de complicaciones&#59; no existe informaci&#243;n contrastada acerca del tipo de anticoagulante &#40;heparinas de bajo peso molecular o dicumar&#237;nicos&#41; y de la duraci&#243;n del tratamiento&#46; La realizaci&#243;n de derivaci&#243;n portosist&#233;mica percut&#225;nea intrahep&#225;tica es t&#233;cnicamente posible en la trombosis sin transformaci&#243;n cavernomatosa y se asocia a recanalizaci&#243;n portal en una proporci&#243;n significativa de casos&#46; El tratamiento trombol&#237;tico no parece presentar un adecuado balance entre eficacia y seguridad&#44; lo que no avala su uso en esta indicaci&#243;n&#46; La correcta definici&#243;n del tratamiento de la trombosis portal requiere de estudios adecuadamente dise&#241;ados para delimitar la eficacia y seguridad de las diferentes alternativas&#46;</p>"
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        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Portal vein thrombosis in cirrhosis is a relatively common complication associated with the presence of an accompanying prothrombotic phenotype of advanced cirrhosis&#46; The consequences of portal vein thrombosis are relevant because it can be associated with impaired hepatic function&#44; might contraindicate hepatic transplantation and could increase morbidity in the surgical procedure&#46; There is controversy concerning the most effective treatment of portal vein thrombosis&#44; which is based on information that is seldom robust and whose primary objective is to achieve a return to vessel patency&#46; Various studies have suggested that starting anticoagulation therapy early is associated with portal vein repatency more frequently than without treatment and has a low rate of complications&#46; There are no proven data on the type of anticoagulant &#40;low-molecular-weight heparins or dicoumarin agents&#41; and the treatment duration&#46; The implementation of TIPS is technically feasible in thrombosis without cavernous transformation and is associated with portal vein recanalization in a significant proportion of cases&#46; Thrombolytic therapy does not appear to present an adequate balance between efficacy and safety&#59; its use is therefore not supported for this indication&#46; The proper definition of treatment for portal vein thrombosis requires properly designed studies to delimit the efficacy and safety of the various alternatives&#46;</p>"
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