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Amnah Alhanaee: Are We Over-Treating Portal Vein Thrombosis in Cirrhosis?
Mar 29, 2026, 16:00

Amnah Alhanaee: Are We Over-Treating Portal Vein Thrombosis in Cirrhosis?

Amnah Alhanaee, Gastroenterologist and Hepatologist at Burjeel Hospital, shared a post on LinkedIn:

“Are we over-treating portal vein thrombosis in cirrhosis?

At the Baveno VIII Consensus Workshop, this question stood out more than any data.

I presented a clinical pathway focused on real-world decision-making in PVT—not just theory, but what actually happens at the bedside.

One key message:

Not all PVT requires anticoagulation

Yet in practice, many patients are automatically anticoagulated… without fully considering:

  • The underlying phenotype
  • Transplant candidacy
  • Extent of thrombosis (e.g., SMV involvement)
  • Timing and need for escalation

The real challenge is not treatment — it’s decision-making under uncertainty.

What we need is:

  • Structured MDT pathways
  • Early and dynamic reassessment
  • Clear triggers for escalation

And most importantly:

  • TIPS should be considered a strategy—not a rescue.

Meetings like Baveno highlight an important gap:

  • Guidelines exist—but real-world decision-making still varies widely.

Curious to hear from colleagues:

  • Do you anticoagulate all PVT in cirrhosis?
  • Or follow a more selective, phenotype-driven approach?”

Amnah Alhanaee: Are We Over-Treating Portal Vein Thrombosis in Cirrhosis?

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