Hybrid Treatment for Budd-Chiari Syndrome: A Case Report by 11-Year Follow-up
Chao Zhang1, Yongquan Gu2, Ce Bian3
1Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Insights
Budd-Chiari syndrome (BCS) treatment can be improved with a hybrid approach. Combining endovascular intervention and a mesocaval shunt offers a successful, long-term solution for BCS patients.
Area of Science:
- Hepatology
- Vascular Surgery
- Interventional Radiology
Background:
- Budd-Chiari syndrome (BCS) is a rare hepatic disease resulting from hepatic venous outflow obstruction.
- Prompt treatment is crucial to prevent severe complications associated with BCS.
- Established therapeutic strategies exist, but recurrence remains a significant challenge.
Observation:
- A young male patient with BCS was treated with a staged hybrid approach.
- This treatment combined endovascular intervention with a mesocaval shunt.
- An 11-year follow-up demonstrated the patient's clinical symptom freedom.
Findings:
- Computed tomography and ultrasonography confirmed the long-term patency of both the endovascular stent and the mesocaval shunt.
- The hybrid treatment effectively alleviated portal and inferior vena cava hypertension.
- This combined approach proved effective in managing BCS and preventing recurrence.
Implications:
- A staged hybrid treatment combining endovascular intervention and mesocaval shunt represents a viable and effective therapeutic strategy for Budd-Chiari syndrome.
- Long-term patency of both interventions suggests a durable solution for BCS management.
- This approach may offer a valuable alternative for patients at high risk of recurrence.
Abstract:
Budd-Chiari syndrome (BCS) is a rare hepatic disease caused by occlusion of the hepatic venous outflow at any level from the small hepatic veins to the atriocava junction. BCS could have serious consequences if not treated promptly. The appropriate therapeutic strategy can be offered to change the natural course of the disease. The present case reports a young man with BCS who successfully received the hybrid treatment combined with endovascular intervention and mesocaval shunt by step. The 11-year follow-up showed that the patient was free of clinical symptoms, and computed tomography and ultrasonography confirmed the patency of the stent and shunt. Although BCS therapy methods are well established, the patient often needs to be treated repeatedly because of the high risk of recurrence. Step therapeutic strategy to alleviate portal and inferior vena cava hypertension of BCS patients are respected. The combination of endovascular intervention and mesocaval shunt was effective in our patient, and both stent and shunt have satisfactory long-term patency.
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