Transjugular Intrahepatic Portosystemic Shunt for Budd-Chiari Syndrome: A Single-Centre Experience

Area of Science:

• Hepatology
• Interventional Radiology
• Vascular Surgery

Background:

• Budd-Chiari syndrome (BCS) presents significant clinical management challenges.
• Understanding BCS aetiology, natural history, and treatment outcomes is advancing.
• Transjugular intrahepatic portosystemic shunt (TIPS) is a key intervention for BCS.

Purpose of the Study:

• To evaluate the outcomes of transjugular intrahepatic portosystemic shunt (TIPS) using covered stents in managing Budd-Chiari syndrome (BCS).
• To assess the efficacy and long-term survival associated with TIPS in BCS patients.

Main Methods:

• Retrospective analysis of 70 BCS patients undergoing TIPS with covered stents (2010-2022).
• Data collection included clinical features, laboratory parameters, and imaging findings pre- and post-TIPS.
• Primary endpoint was overall survival; secondary endpoints included shunt dysfunction and revision rates.

Main Results:

• TIPS was performed in 70 of 88 BCS patients; 18 required liver transplantation.
• Excellent 1, 3, and 5-year survival rates: 98.8%, 97.9%, and 97.7%, respectively.
• TIPS alone showed better survival than BCS patients requiring liver transplantation (p=0.003); covered stents reduced shunt dysfunction.

Conclusions:

• Transjugular intrahepatic portosystemic shunt (TIPS) is a highly effective treatment for Budd-Chiari syndrome (BCS).
• Covered stents are crucial for reducing shunt dysfunction rates in TIPS procedures for BCS.
• Long-term outcomes are favorable, even with repeated TIPS revisions, highlighting its therapeutic value.