A related comment notes that splanchnic vein thrombosis (SVT) is a relatively uncommon venous thrombotic condition. Therefore even though this research is observational, it holds importance as it comprises a large cohort, focuses on therapeutic interventions and outcomes, and has a relatively long follow-up period. There are many limitations to observational studies but the results can be helpful to clinicians in making decisions regarding treatment for patients with SVT, in the absence of randomized trials.
Seventy-seven percent (n = 465) of the enrolled patients received anticoagulant therapy (62.4% vitamin K antagonist and 37.6% parenteral therapy). The author of the comment states that the most interesting finding was that anticoagulant treatment duration appeared to not only reduce recurrent thrombosis but also reduce bleeding. Those who received an anticoagulant experienced less bleeding (3.9% per 100 patient-years) compared with those who did not receive treatment (5.8% per 100 patient-years). Selection bias may be a factor in this, but if confirmed then it would suggest that anticoagulants should be used more frequently in SVT.
Because of the serious underlying disorders associated with most cases of SVT, the long-term risk-benefit profile is likely to be different than those seen with deep vein thrombosis and pulmonary embolism, and more long-term outcome data are needed.