We read with interest the recent systematic review and meta-analysis of anticoagulation for portal vein thrombosis (PVT) for individuals with cirrhosis from Loffredo et al.1 PVT is a frequent complication of cirrhosis and the sequelae can include mesenteric ischemia and decompensation of stable chronic liver disease. PVT is considered an additional risk factor for variceal bleeding over and above the background risk associated with cirrhosis. It is, however, reported that the development of PVT is often asymptomatic, is related to the advanced stage of cirrhosis in many cases, and in some patients may resolve spontaneously.