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Long-Term Outcomes of Endovascular Interventions in More than 500 patients with Budd-Chiari Syndrome

Naren Hemachandran1, Shalimar2, Subrat Acharya2

  • 1Department of Radiodiagnosis, All India Institute of Medical Sciences, Room no. 81b, Ansari Nagar, New Delhi 110029, India.

Journal of Vascular and Interventional Radiology : JVIR
|November 21, 2020
PubMed

Insights

Endovascular interventions for Budd-Chiari syndrome (BCS) demonstrate high technical success and safety. These procedures offer excellent long-term patency and survival rates for patients with BCS.

Area of Science:

  • Interventional Radiology
  • Hepatology
  • Vascular Surgery

Background:

  • Budd-Chiari syndrome (BCS) is a rare condition characterized by hepatic venous outflow obstruction.
  • Effective long-term management strategies for BCS are crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate and compare the long-term efficacy of diverse endovascular interventions in patients diagnosed with Budd-Chiari syndrome.
  • To analyze technical success, clinical outcomes, patency rates, complications, and survival following endovascular treatment for BCS.

Main Methods:

  • A single-center retrospective analysis included 510 consecutive patients with BCS undergoing 618 endovascular procedures (January 2001-December 2019).
  • Interventions comprised recanalization (angioplasty/stenting) and transjugular intrahepatic portosystemic shunt (TIPS) creation.
  • Data collected included technical success, clinical success, patency, complications, and survival rates.

Main Results:

  • Overall technical success rate was 96%. Recanalization procedures were performed in 71% and TIPS in 29% of patients.
  • Major complications occurred in 2.8% of cases. Vascular/stent restenosis was observed in 19%, with successful reintervention in 86.3%.
  • One- and 5-year cumulative patency rates were 87%/74% (recanalization) and 95%/68% (TIPS). One- and 5-year survival rates were 96%/89% (recanalization) and 90%/76% (TIPS).

Conclusions:

  • Endovascular interventions are a feasible and safe treatment modality for the majority of patients with Budd-Chiari syndrome.
  • These procedures yield excellent short- and long-term patency and survival rates, underscoring their therapeutic value in managing BCS.
Abstract

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