Regarding the ‘Role of low-molecular-weight heparins in prevention of thromboembolic complication after transarterial chemoembolization in hepatocellular carcinoma’

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We read with great interest the recent article by Negm et al. 1. They raised an important issue on the complication after transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC). The authors concluded that the incidence of portal vein thrombosis (PVT) after TACE was higher in the TACE-only group than the TACE plus low-molecular-weight heparins group (35 vs. 5%). However, we would like to elaborate on the PVT after TACE in HCC.
The authors reported there were no significant difference in the baseline Child classification, α-fetoprotein, and portal vein velocity in both groups. However, considerable important information was missing for the two groups, such as arteriovenous shunting and portal vein tumor thrombus. We do not know whether the two groups of patients are comparable without this information. This may have biased the results of this report.
Although there are many complications of TACE in HCC, PVT after TACE is rare 2,3. It may be helpful to the reader to understand why the incidence of PVT after TACE is so high (≤35%) in this study if the authors provide more information.

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