Related Experiment Video
Updated: Feb 28, 2026
Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
Published on: August 26, 2025
Budd-Chiari syndrome: outcomes of endovascular intervention-A single-center experience
Nitin Jagtap1, Mithun Sharma2, Jagdeesh Singh2
1Department of Gastroenterology and Hepatology, Asian Institute of Gastroenterology, Somajiguda, Hyderabad, 500 082, India. docnits13@gmail.com.
Insights
Endovascular interventions are effective for Budd-Chiari syndrome (BCS) management, showing high success rates. The Model for End-Stage Liver Disease (MELD) score is a key predictor of outcomes in these patients.
Area of Science:
- Interventional Radiology
- Hepatology
- Vascular Surgery
Background:
- Budd-Chiari syndrome (BCS) management outcomes via endovascular intervention vary.
- A critical evaluation of clinical outcomes and prognostic scores in BCS is needed.
Purpose of the Study:
- To evaluate clinical outcomes of endovascular interventions in Budd-Chiari syndrome (BCS).
- To assess the role of prognostic scores in predicting outcomes for BCS patients undergoing endovascular procedures.
Main Methods:
- Retrospective analysis of 88 BCS patients undergoing endovascular intervention (2007-2016).
- Documentation of technical success, clinical success, and complications.
- Assessment of prognostic scores (CTP, MELD, Rotterdam, Clichy) for predicting mortality, clinical success, and re-intervention needs.
Main Results:
- High technical (98.86%) and clinical (86.36%) success rates were achieved.
- 1-, 2-, 3-, and 4-year stent patency rates were 90.91%, 81.08%, 74.59%, and 70.45%, respectively.
- Only Model for End-Stage Liver Disease (MELD) >14 predicted outcomes; other scores did not.
Conclusions:
- Endovascular interventions are crucial for managing selected BCS patients.
- Favorable outcomes are achievable even with unfavorable prognostic scores, highlighting the importance of intervention selection.
Aim:
Outcomes of endovascular intervention in Budd-Chiari syndrome (BCS) have been reported with varied results. Clinical outcomes of endovascular interventions in BCS and role of various prognostic scores were critically evaluated in this study.
Methods:
This study retrospectively analyzed consecutive patients of BCS who underwent endovascular intervention between January 2007 and May 2016 at our center. Technical, clinical successes and complications were documented. The role of the prognostic scores such as Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), Rotterdam index, and original Clichy score in predicting mortality, clinical success, and need for re-interventions were also assessed.
Results:
A total of 88 patients were analyzed. The median follow up was 12 months (range 1-96 months). Thirteen (14.8%) patients had combined inferior vena cava (IVC) and hepatic vein (HV) obstruction; HV obstruction in 33 (37.5%) and inferior vena cava IVC obstruction in 42 (47.7%) patients. The following interventions were done: IVC angioplasty alone (n = 11), IVC angioplasty with stenting (n = 36), HV angioplasty with stenting (n = 26), combined HV and IVC stent (n = 2), and direct intrahepatic porto-systemic shunt (DIPS) (n = 13). Overall technical success was 87/88 (98.86%), and clinical success was 76/88 (86.36%). Immediate complications were noted in 8 patients (10%). The 1-, 2-, 3-, and 4-year stent patency rates were 90.91%, 81.08%, 74.59%, and 70.45%, respectively. Re-interventions were required in 15 (17%). Overall mortality was 6 (6.8%). Apart from MELD >14, none of the other prognostic score could predict mortality, clinical success, and need for re-interventions.
Conclusion:
Endovascular interventions play an important role in the management of BCS, in properly selected patients, even if prognostic score is unfavorable.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...