Budd-Chiari Syndrome: Update on Classification and Intravascular US

Area of Science:

• Interventional Radiology
• Hepatology
• Vascular Medicine

Background:

• Budd-Chiari syndrome (BCS) arises from hepatic venous outflow obstruction, leading to sinusoidal congestion, portal hypertension, and potential cirrhosis.
• Obstruction can affect hepatic veins (HVs) or the inferior vena cava (IVC), presenting globally or segmentally.
• Effective treatment necessitates a thorough understanding of causal factors, lesion characteristics, clinical status, and liver function.

Purpose of the Study:

• To highlight the importance of the Budd-Chiari syndrome (BCS) classification system in guiding interventional therapy.
• To underscore the utility of intravascular ultrasound (IVUS) in characterizing BCS lesions and aiding treatment decisions.
• To emphasize the role of radiologists in understanding the BCS classification for optimal patient management.

Main Methods:

• Review and application of the established Budd-Chiari syndrome (BCS) classification system.
• Utilization of intravascular ultrasound (IVUS) for detailed lesion characterization and procedural guidance.
• Analysis of treatment strategies including angioplasty, stent placement, and portosystemic shunt creation.

Main Results:

• The BCS classification system provides a framework for standardizing diagnosis and interventional therapy.
• IVUS aids in BCS lesion characterization, guiding decisions on stent placement and portosystemic shunt creation.
• IVUS can improve procedural efficiency and success rates while reducing radiation and contrast agent use.

Conclusions:

• A comprehensive understanding of the BCS classification system is essential for radiologists.
• Intravascular ultrasound (IVUS) is a valuable tool for characterizing BCS lesions and optimizing interventional procedures.
• Integrating the BCS classification with IVUS facilitates tailored and effective treatment strategies for Budd-Chiari syndrome.