Proceedings of the 13th International Conference on Thrombosis and Hemostasis Issues in Cancer, 2026
Vol. 5 No. s1 (2026)
The therapeutic landscape of cancer-associated splanchnic vein thrombosis
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 16 April 2026
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Splanchnic vein thrombosis (SVT), including portal, splenic, and mesenteric vein thrombosis and the Budd–Chiari syndrome, is an uncommon manifestation of venous thromboembolism frequently associated with solid abdominal malignancies and myeloproliferative neoplasms (MPNs). The management of cancer-associated SVT is challenging due to heterogeneous clinical presentations, competing risks of thrombosis and bleeding, and the lack of high-quality clinical studies in this setting. Based on available evidence, anticoagulation is associated with higher rates of recanalization in patients with solid cancer, with no impact on the mortality rates and a non-negligible bleeding risk. Most available data derive from observational studies, with low-molecular-weight heparin (LMWH) historically representing the most frequently used anticoagulant, although direct oral anticoagulants (DOACs) are increasingly prescribed following evidence from cancer-associated thrombosis in usual sites. In MPN-associated SVT, anticoagulation is generally recommended indefinitely in combination with cytoreductive therapy. Available cohort studies suggest comparable outcomes among vitamin K antagonists (VKAs), LMWH, and DOACs, but robust comparative data are lacking. Overall, current evidence supports an individualized, risk-adapted anticoagulant approach in patients with cancer-associated SVT.
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How to Cite
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Abenante A, Catalani F, Ageno W. The therapeutic landscape of cancer-associated splanchnic vein thrombosis. Bleeding Thromb Vasc Biol [Internet]. 2026 Apr. 16 [cited 2026 Apr. 17];5(s1). Available from: https://www.btvb.org/btvb/article/view/458
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