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?”

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