Percutaneous recanalization for hepatic vein-type Budd-Chiari syndrome: long-term patency and survival

Area of Science:

• Interventional Radiology
• Hepatology
• Vascular Surgery

Background:

• Budd-Chiari syndrome (BCS) is a rare condition characterized by obstruction of hepatic venous outflow.
• HV-type BCS specifically involves the hepatic veins, leading to significant morbidity and mortality.
• Effective treatment strategies are crucial for managing this complex liver disease.

Purpose of the Study:

• To evaluate the long-term efficacy of percutaneous recanalization in treating hepatic vein (HV)-type Budd-Chiari syndrome (BCS).
• To assess the patency rates and patient survival following this interventional procedure.
• To determine the safety and clinical success of restoring HV flow.

Main Methods:

• A cohort of 143 symptomatic HV-type BCS patients underwent percutaneous recanalization between March 2009 and November 2014.
• Procedures included recanalization of main hepatic veins (MHV) or accessory hepatic veins (AHV).
• Technical and clinical success, pressure changes, re-obstruction rates, patency, and survival were meticulously analyzed.

Main Results:

• Technical success was achieved in 140 of 143 patients, with significant pressure reduction post-procedure (33.5 to 12.5 mmHg).
• The 1-, 3-, and 6-year primary patency rates were 91.1%, 77.4%, and 74.0%, respectively.
• Cumulative survival rates at 1, 3, and 6 years were high (97.7%, 92.2%, and 90.0%), indicating favorable long-term outcomes.

Conclusions:

• Percutaneous recanalization is a highly effective treatment for HV-type BCS.
• The procedure demonstrates excellent long-term patency and survival rates.
• This minimally invasive approach offers a valuable therapeutic option for BCS patients.