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Thromb Haemost 1997; 77(01): 044-047
DOI: 10.1055/s-0038-1655904
Clinical Studies
Schattauer GmbH Stuttgart

Ongoing Prothrombotic State in the Portal Circulation of Cirrhotic Patients

Francesco Violi
1   The Istituto I Clinica Medico, Università “La Sapienza”, Rome, Italy
,
Domenico Ferro
1   The Istituto I Clinica Medico, Università “La Sapienza”, Rome, Italy
,
Stefania Basili
1   The Istituto I Clinica Medico, Università “La Sapienza”, Rome, Italy
,
Raffaella Lionetti
2   The II Cattedra di Gastroenterologia, Università “La Sapienza”, Rome, Italy
,
Elisabetta Rossi
1   The Istituto I Clinica Medico, Università “La Sapienza”, Rome, Italy
,
Manuela Merli
2   The II Cattedra di Gastroenterologia, Università “La Sapienza”, Rome, Italy
,
Oliviero Riggio
2   The II Cattedra di Gastroenterologia, Università “La Sapienza”, Rome, Italy
,
Mario Bezzi
3   Istituto di Radiologia, Università “La Sapienza”, Rome, Italy
,
Livio Capocaccia
2   The II Cattedra di Gastroenterologia, Università “La Sapienza”, Rome, Italy
› Author Affiliations
Further Information

Publication History

Received 25 July 1996

Accepted after revision 24 September 1996

Publication Date:
11 July 2018 (online)

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Summary

Portal thrombosis may complicate the clinical course of cirrhosis, but the pathophysiologic mechanism is unclear. Aim of the study was to evaluate the behavior of clotting system and endotoxemia in portal vein and in peripheral circulation of 11 cirrhotic patients undergoing transjugular port-systemic shunt (TIPS).

Portal blood showed higher values of Fl+2 [Median (range): 2.5 (1.1-5.3) vs. 1.1 (0.6-2.1) nM, p <0.01], D-dimer [765 (184-1713) vs. 192 (64-813) ng/ml, p < 0.01] and endotoxemia [31 (16-47.2) vs. 13.7 (7.5-23.5) pg/ml, p <0.01] than peripheral circulation. In the portal vein, all but one sample had Fl+2 > 1.2 nM (upper limit of control values), all but one had D-dimer > 216 mg/dl (mean + 2 SD of controls) and 100% had values of endotoxemia > 9.6 pg/ml (upper limit of control values). Fibrinogen was lower in the portal circulation compared to peripheral circulation but the difference was not significant [85 (58-195) vs. 134 (75-244) mg/dl, p > 0.05].

Endotoxemia was directly correlated with Fl+2 (Rho = 0.92 p <0.006) and D-dimer (Rho = 0.93, p <0.005).

This study shows that an ongoing prothrombotic state is present in the portal circulation of cirrhotic patients and may play a pivotal role in the thrombotic episodes occurring in this clinical setting.

 

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