We read with great interest the systematic review and meta-analysis by Loffredo et al1 comparing the effect of anticoagulation therapy with no treatment on portal vein thrombosis (PVT) in cirrhotic patients. As expected, the recanalization rate was significantly improved in anticoagulated patients. More important, the risk of spontaneous variceal bleeding was considerably decreased in these patients, which was demonstrated for the first time. However, we believe further comments for these findings are appropriate.