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| 1 | Therapeutic and clinical aspects of portal vein thrombosis in patients with cirrhosis显示文摘Portal vein thrombosis(PVT) is a frequent complication in cirrhosis, particularly in advanced stages of the disease. As for general venous thromboembolism, risk factors for PVT are slow blood flow, vessel wall damage and hypercoagulability, all features of advanced cirrhosis. Actually, the old dogma of a hemorrhagic tendency in cirrhosis has been challenged by new laboratory tools and the clinical evidence that venous thrombosis also occurs in cirrhosis. The impaired hepatic synthesis of both pro- and anticoagulants leads to a rebalanced hemostasis, more liable to be tipped towards thrombosis or even bleeding. Conventional anticoagulant drugs(low molecular weight heparin or vitamin K antagonists) may be used in cirrhosis patients with PVT, particularly in those eligible for liver transplantation, to prevent thrombosis progression thus permitting/facilitating liver transplant. However, several doubts exist on the level of anticoagulation achieved as estimated by coagulation tests, on the efficacy of treatment monitoring and on the correct timing for discontinuation in non-transplant candidates, while in transplant candidates there is expert consensus on continuing anticoagulation until transplantation. The recent introduction of direct acting oral anticoagulant drugs(DOACs) in other clinical settings generates much interest on their possible application in patients with cirrhosis and PVT. However, DOACs were not evaluated yet in patients with liver disease and cannot be recommended for the present time. | Massimo Primignani Giulia Tosetti Vincenzo La Mura | 2015 | World Journal of Hepatology2015，7，29： | 13 |
| 2 | Cirrhosis and portal hypertension: The importance of risk stratification, the role of hepatic venous pressure gradient measurement显示文摘Portal hypertension is the main prognostic factor in cirrhosis. The recent emergence of potent antiviral drugs and new algorithm of treatment for the management of complications due to portal hypertension have sensibly changed our perception of cirrhosis that can be now considered as a multistage liver disease whose mortality risk can be reduced by a tailored approachfor any stage of risk. Experts recommend to move toward a pathophysiological classification of cirrhosis that considers both structural and functional changes. The hepatic venous pressure gradient HVPG, is the reference gold standard to estimate the severity of portal hypertension in cirrhosis. It correlates with both structural and functional changes that occur in cirrhosis and carries valuable prognostic information to stratify the mortality risk. This article provides a general overview of the pathophysiology and natural course of cirrhosis and portal hypertension. We propose a simplified classification of cirrhosis based on low, intermediate and high mortality stage. The prognostic information provided by HVPG is presented according to each stage. A comparison with prognostic models based on clinical and endoscopic variables is discussed in order to evidence the additional contribute given by HVPG on top of other clinical and instrumental variables widely used in clinical practice. | Vincenzo La Mura Antonio Nicolini Giulia Tosetti Massimo Primignani | 2015 | World Journal of Hepatology2015，7，4： | 10 |
| 3 | Use of non-selective beta blockers in cirrhosis:The evidence we need before closing(or not) the window显示文摘Non selective beta blockers(NSBBs)are used in primary and secondary prophylaxis of portal hypertensionrelated bleeding in patients with cirrhosis.The efficacy of NSBBs treatment is predicted by hemodynamic response in term of reduction of the hepatic venouspressure gradient(HVPG)below 12 mm Hg or at least20%of the basal value.Nevertheless a relevant number of patients who do not achieve this HVPG reduction during NSBBs therapy do not bleed during follow up;this evidence suggests an additional non-hemodynamic advantage of NSBBs treatment to modify the natural history of cirrhosis.Recent studies have questioned the efficacy and safety of NSBBs in patients with advanced stage of liver disease characterized by refractory ascites and/or spontaneous bacterial peritonitis.These studies have suggested the existence of a defined and limited period to modify the natural history of cirrhosis by NSBBs:the'window hypothesis'.According with this hypothesis,patients with cirrhosis benefit from the use of NSBBs from the appearance of varices up to the development of an advanced stage of cirrhosis.Indeed,in patients with refractory ascites and/or spontaneous bacterial peritonitis the hemodynamic effects of NSBBs may expose to a high risk of further complications such as renal insufficiency and/or death.Methodological concerns and contrasting results counterbalance the evidence produced up to now on this issue and are the main topic of this editorial. | Vincenzo La Mura Giulia Tosetti Massimo Primignani Francesco Salerno | 2015 | World Journal of Gastroenterology2015，21，8： | 4 |
| 4 | TIPS for Budd-Chiari Syndrome: Long-Term Results and Prognostics Factors in 124 Patients显示文摘 | Juan Carlos Garcia–Pagán Mathis Heydtmann Sebastian Raffa Aurélie Plessier Sarwa Murad Federica Fabris Giovanni Vizzini Juan Gonzales Abraldes Simon Olliff Antonio Nicolini Angelo Luca Massimo Primignani Harry L.A. Janssen Dominique Valla Elwyn Elias Jaum | 2008 | Gastroenterology2008，，3： | 3 |
| 5 | Procoagulant Imbalance in Patients with Nonalcoholic Fatty Liver Disease显示文摘 | Armando Tripodi Anna L. Fracanzani Massimo Primignani Veena Chantarangkul Marigrazia Clerici Pier Mannuccio Mannucci Flora Peyvandi Cristina Bertelli Luca Valenti Silvia Fargion | 2014 | Journal of Hepatology2014，，： | 1 |
| 6 | Evidence that low protein C contributes to the procoagulant imbalance in cirrhosis<!-- Doctopic: CIRR -->显示文摘 | Armando Tripodi Massimo Primignani Laura Lemma Veena Chantarangkul Pier Mannuccio Mannucci | 2013 | Journal of Hepatology2013，，2： | 1 |
| 7 | An Imbalance of Pro- vs Anti-Coagulation Factors in Plasma From Patients With Cirrhosis显示文摘 | Armando Tripodi Massimo Primignani Veena Chantarangkul Alessandra Dell’Era Marigrazia Clerici Roberto de Franchis Massimo Colombo Pier Mannuccio Mannucci | 2009 | Gastroenterology2009，，6： | 1 |
| 8 | Good long‐term outcome of Budd‐Chiari syndrome with a step‐wise management显示文摘 | Susana Seijo Aurelie Plessier Jildou Hoekstra Alessandra Dell’Era Dalvinder Mandair Kinan Rifai Jonel Trebicka Isabelle Morard Luc Lasser Juan G. Abraldes Sarwa Darwish Murad J?rg Heller Antoine Hadengue Massimo Primignani Elwyn Elias Harry L.A. Janssen D | 2013 | Hepatology2013，，5： | 1 |
| 9 | TIPS for Budd-Chiari Syndrome: Long-Term Results and Prognostics Factors in 124 Patients显示文摘 | Juan Carlos Garcia–Pagán Mathis Heydtmann Sebastian Raffa Aurélie Plessier Sarwa Murad Federica Fabris Giovanni Vizzini Juan Gonzales Abraldes Simon Olliff Antonio Nicolini Angelo Luca Massimo Primignani Harry L.A. Janssen Dominique Valla Elwyn Elias Jaum | 2008 | Gastroenterology2008，，3： | 1 |
| 10 | Evidence that low protein C contributes to the procoagulant imbalance in cirrhosis<!-- Doctopic: CIRR -->显示文摘 | Armando Tripodi Massimo Primignani Laura Lemma Veena Chantarangkul Pier Mannuccio Mannucci | 2013 | Journal of Hepatology2013，，2： | 1 |
| 11 | Detection of the imbalance of procoagulant versus anticoagulant factors in cirrhosis by a simple laboratory method显示文摘 | Armando Tripodi Massimo Primignani Laura Lemma Veena Chantarangkul Alessandra Dell’Era Francesca Iannuzzi Alessio Aghemo Pier Mannuccio Mannucci | 2010 | Hepatology2010，，1： | 1 |
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