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Interventional Treatment Strategy for Primary Budd-Chiari Syndrome with Both Inferior Vena Cava and Hepatic Vein

De-Lei Cheng1,2, Hao Xu3, Cheng-Li Li2

  • 1Department of Interventional Radiology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, People's Republic of China.

Cardiovascular and Interventional Radiology
|June 21, 2019
PubMed

Insights

Interventional treatments like recanalization and balloon angioplasty effectively manage Budd-Chiari syndrome (BCS) involving hepatic vein (HV) and inferior vena cava (IVC) occlusions. Most patients improved with IVC recanalization alone.

Area of Science:

  • Interventional Radiology
  • Vascular Medicine
  • Hepatology

Background:

  • Budd-Chiari syndrome (BCS) involves combined obstruction of the inferior vena cava (IVC) and hepatic veins (HVs).
  • Effective management strategies for BCS are crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of interventional treatments for BCS with combined IVC and HV occlusions.
  • To compare outcomes between IVC-only interventions and combined HV and IVC interventions.

Main Methods:

  • Retrospective study of 162 patients with BCS.
  • Interventional treatments included recanalization, balloon dilation, and stent placement.
  • Pre- and post-intervention imaging (ultrasound, CT, MRI), venography, and manometry were performed.

Main Results:

  • Recanalization success rates were 96% for combined HV/IVC and 97% for IVC occlusions.
  • Clinical symptoms resolved in 82.4% after the first intervention and 94.2% after the second.
  • Outcomes for IVC-only intervention were similar to combined HV and IVC interventions.

Conclusions:

  • Recanalization and balloon angioplasty are effective for managing BCS with concurrent HV and IVC occlusions.
  • IVC recanalization alone is often sufficient, yielding outcomes comparable to combined interventions.
  • Interventional therapy significantly improves clinical symptoms in BCS patients.
Abstract

Keywords:
Budd–Chiari syndromeHepatic veinsInterventional treatmentSurvival rate

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