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Exp Ther Med. 2018 Nov;16(5):4141-4149. doi: 10.3892/etm.2018.6708. Epub 2018 Sep 7.

Outcomes of endovascular interventional therapy for primary Budd-Chiari syndrome caused by hepatic venous obstruction.

Author information

1
Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong 250021, P.R. China.
2
Department of Interventional Radiology, Anhui Provincial Hospital, Hefei, Anhui 230000, P.R. China.
3
Department of Radiology, People's Hospital of Wuhe County, Bengbu, Anhui 233300, P.R. China.
4
Department of Interventional Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221100, P.R. China.

Abstract

To date, interventional therapy for patients with Budd-Chiari syndrome (BCS) due to hepatic vein obstruction (HVO) has not been standardized in China. In Western countries, BCS primarily occurs due to thrombosis and the majority of patients receive thrombolysis. In China, BCS is mostly caused by the membranous occlusion of the HV or IVC. The present retrospective study evaluated the efficacy of recanalization techniques in patients with primary BCS due to HVO. The data of 69 patients with BCS due to HVO, who underwent endovascular therapy at 2 centers in China between December 2010 and December 2012, were analyzed. All of the patients underwent balloon angioplasty. In addition, 14, 6 and 5 patients received thrombolysis, endovascular stent and thrombolysis + endovascular stent, respectively. The overall technical success rate was 95.7% (66/69), and was comparable among the treatments. The HV pressure after the treatments was significantly lower compared with that prior to the procedures (23.3±6.9 vs. 46.5±8.6 cmH2O; P<0.001). The mean follow-up duration was 75 months (range, 60-84 months). During the 5-year follow-up, 10 patients (15.2%) had developed a recurrence of BCS-associated symptoms, of which 7 were successfully treated. The cumulative survival rates at 12, 36 and 60 months after endovascular interventional therapy (balloon angioplasty or combined treatment) were 98.5, 98.5 and 93.9%, respectively. After treatment by endovascular therapy, the patients with BCS caused by HVO had high survival rates and low recurrence rates in the short- and mid-term.

KEYWORDS:

Budd-Chiari syndrome; angioplasty; hepatic vein; interventional therapy; stenting; thrombolysis

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