{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T05:06:04Z","timestamp":1761541564394,"version":"3.41.2"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T00:00:00Z","timestamp":1597104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Splanchnic vein thrombosis (SVT) is an uncommon but potentially life\u2010threatening disease usually related to different underlying clinical conditions. The risk of SVT recurrences is high over time in patients with an underlying permanent prothrombotic condition. Vitamin K antagonists (VKA) represent the mainstay of treatment for SVT. Data about the efficacy and safety of direct oral anticoagulants (DOACs) are reported in the literature for the treatment of acute SVT, but less is known about their application for the secondary prophylaxis of venous thromboembolism (VTE). The aim of this study was to assess the efficacy and safety of long\u2010term DOACs therapy in patients at high\u2010risk of thrombosis, compared to VKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective single\u2010centre study including 70 patients with SVT on long\u2010term anticoagulant treatment with VKA followed\u2010up at our Units between January 2017 and December 2019. All the patients were at high thrombotic risk defined as the presence of a permanent prothrombotic condition requiring long\u2010term anticoagulation. During follow\u2010up, 28 patients were shifted to DOACs and their clinical outcomes were compared to those of the patients who continued VKA therapy. All the arterial and venous thrombotic events of the splanchnic and extra\u2010splanchnic districts as well as the haemorrhagic adverse events occurring during follow\u2010up were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the seventy patients enrolled in the study, 36 patients (51.4%) had a single\u2010segment involvement thrombosis (28.5% of portal vein, 7.1% of superior mesenteric vein, 4.3% of splenic vein, 11.5% of hepatic veins) and 34 patients (48.6%) had multi\u2010segment involvement at the time of diagnosis. 42 patients (60%) continued VKA therapy and 28 (40%) were switched to DOACs. Median follow\u2010up was 6\u00a0years (range 2\u20108) during VKA and 1.9\u00a0years (range 1\u20105.2) during DOACs. The incidence of thrombotic events was similar between patients on VKA and those on DOACs. Patients on VKA developed deep vein thrombosis (DVT), and of the patients on DOACs 1 developed NSTEMI and 1 DVT. No major haemorrhagic events occurred. Minor bleedings occurred in 26% of patients on VKA and in none of the DOACs patients (<jats:italic>P<\/jats:italic>: 0.09).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results highlight that DOACs could represent an effective and safe alternative to the VKA for secondary prophylaxis in SVT patients at high risk of thrombosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13356","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T21:00:06Z","timestamp":1595624406000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Outcomes of long\u2010term anticoagulant treatment for the secondary prophylaxis of splanchnic venous thrombosis"],"prefix":"10.1111","volume":"51","author":[{"given":"Alessandra","family":"Serrao","sequence":"first","affiliation":[{"name":"Hematology Department of Translational and Precision Medicine Sapienza University Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Merli","sequence":"additional","affiliation":[{"name":"Gastroenterology Department of Translational and Precision Medicine Sapienza University Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedetta","family":"Lucani","sequence":"additional","affiliation":[{"name":"Hematology Department of Translational and Precision Medicine Sapienza University Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Aprile","sequence":"additional","affiliation":[{"name":"Gastroenterology Department of Translational and Precision Medicine Sapienza University Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciano","family":"Fiori","sequence":"additional","affiliation":[{"name":"Hematology Department of Translational and Precision Medicine Sapienza University Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Gioia","sequence":"additional","affiliation":[{"name":"Gastroenterology Department of Translational and Precision Medicine Sapienza University Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Breccia","sequence":"additional","affiliation":[{"name":"Hematology Department of Translational and Precision Medicine Sapienza University Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivero","family":"Riggio","sequence":"additional","affiliation":[{"name":"Gastroenterology Department of Translational and Precision Medicine Sapienza University Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2593-1376","authenticated-orcid":false,"given":"Antonio","family":"Chistolini","sequence":"additional","affiliation":[{"name":"Hematology Department of Translational and Precision Medicine Sapienza University Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23259"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-07-551515"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.09.019"},{"issue":"1","key":"e_1_2_7_5_1","first-page":"99","article-title":"Antithrombotic treatment of splanchnic vein thrombosis: results of an international registry","volume":"40","author":"Ageno W","year":"2014","journal-title":"Semin Thromb 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