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Published on: August 26, 2025
Endovascular treatment of Budd-Chiari syndrome
Qing-Yi Meng1, Nian-Feng Sun, Jia-Xiang Wang
1Department of Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.
Insights
Interventional therapy offers a safe and effective treatment for Budd-Chiari syndrome (BCS), a condition causing portal hypertension due to hepatic vein or inferior vena cava obstruction. This approach leads to rapid recovery and is becoming a primary treatment option.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Hepatology
Background:
- Budd-Chiari syndrome (BCS) is characterized by posthepatic portal hypertension resulting from hepatic vein or inferior vena cava (IVC) obstruction.
- Understanding the efficacy of interventional approaches is crucial for managing this condition.
Purpose of the Study:
- To evaluate the clinical outcomes and safety of interventional therapy for Budd-Chiari syndrome.
- To assess the long-term effectiveness of endovascular procedures in BCS management.
Main Methods:
- The study involved IVC venography followed by balloon angioplasty and routine stent implantation for occlusive or stenotic lesions.
- Interventions targeted both the IVC (760 cases) and hepatic veins (61 cases).
Main Results:
- Successful intervention was achieved in 821 out of 903 cases.
- Complications included acute renal failure (8 cases), hepatic coma (2 cases), and acute heart failure (43 cases).
- Recurrence was observed in 59 out of 679 follow-up cases.
Conclusions:
- Interventional therapy demonstrates safety and efficacy for most BCS types, facilitating rapid patient recovery.
- This minimally invasive approach is increasingly recognized as the preferred initial treatment for Budd-Chiari syndrome.
Background:
Budd-Chiari syndrome (BCS) is a posthepatic portal hypertension caused by the obstruction of the lumen of the hepatic veins or the proximal inferior vena cava (IVC). This study aimed to evaluate the clinical experience of interventional therapy for Budd-Chiari syndrome.
Methods:
IVC venography was carried out first, the obliteration or stenosis in the IVC was opened or dilated with the hard guided wire or Rups100 puncture needle and balloon, then a stent was routinely implanted for the type of obliteration or stenosis.
Results:
The procedure was successful in 821 out of 903 cases including IVC intervention in 760 cases, and hepatic vein intervention in 61 cases. An IVC stent was used in 517 cases and hepatic vein stent in 19 cases. There were no pulmonary embolisms, but acute renal failure occurred in eight cases, hepatic coma in two cases and acute heart failure in 43 cases. Two patients died in this group and five cases were complicated with acute IVC thrombosis. Follow up of 7 to 124 months was made in 679 cases with recurrence found in 59 cases.
Conclusions:
Interventional therapy is safe and effective with a fast recovery for most types of BCS. It is gradually becoming the first therapeutic choice.
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