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CardioVascular and Interventional Radiology

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01-09-2019 | Phlebography | Clinical Investigation

Interventional Treatment Strategy for Primary Budd–Chiari Syndrome with Both Inferior Vena Cava and Hepatic Vein Involvement: Patients from Two Centers in China

Authors: De-lei Cheng, Hao Xu, Cheng-li Li, Wei-fu Lv, Chuan-ting Li, Gauri Mukhiya, Wei-wei Fang

Published in: CardioVascular and Interventional Radiology | Issue 9/2019

Abstract

Objective

This retrospective study evaluated interventional treatments (recanalization, balloon dilation, and/or stent placement) for Budd–Chiari syndrome (BCS), caused by combined obstruction of the inferior vena cava (IVC) and hepatic veins (HVs).

Methods

Before and after interventional therapy, patients with BCS (n = 162; asymptomatic 105.2 ± 103.3 mo; follow-up 15 [6–24] mo) underwent imaging studies (color Doppler ultrasound, CT, or MRI), and inferior vena cavography and manometry. Venous lesions were characterized by occlusion features, and presence of thrombosis and peripheral collateral vessels.

Results

One, 2, and 3 main HV occlusions were observed, respectively, in 25 (15.4%), 61 (37.7%), and 76 (46.9%) patients. Eighty-three (51.2%), 98 (60.5%), and 104 (64.2%) patients had, respectively, large accessory HVs, venous collaterals formed between the HVs, or venous communicating branches between the HV and the peritoneal veins. The middle, left, and right HV was patent in 32 (19.8%), 35 (21.6%), and 44 (27.2%) patients. Recanalization of both hepatic and caval occlusions was successful in 96% (51/53) of those attempted; recanalization of IVC occlusion was successful in 97% (106/109). Among 157 patients successfully treated, 146 were cured and 11 showed clinical improvement. Clinical symptoms were relieved in 82.4% after the initial intervention, and 94.2% after the second intervention.

Conclusion

Recanalization and balloon angioplasty was effective for the management of BCS with concurrent HV and IVC occlusions. The majority of patients required only IVC recanalization. The outcome of patients treated only by IVC intervention was similar to that of patients given combined HV and IVC intervention.

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Title: Interventional Treatment Strategy for Primary Budd–Chiari Syndrome with Both Inferior Vena Cava and Hepatic Vein Involvement: Patients from Two Centers in China
Authors: De-lei Cheng
Hao Xu
Cheng-li Li
Wei-fu Lv
Chuan-ting Li
Gauri Mukhiya
Wei-wei Fang
Publication date: 01-09-2019
Publisher: Springer US
Keyword: Phlebography
Published in: CardioVascular and Interventional Radiology / Issue 9/2019
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-019-02267-w

At a glance: The STEP trials

Springer Medicine

Interventional Treatment Strategy for Primary Budd–Chiari Syndrome with Both Inferior Vena Cava and Hepatic Vein Involvement: Patients from Two Centers in China

Abstract

Objective

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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