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Use of Accessory Hepatic Vein Intervention in the Treatment of Budd–Chiari Syndrome

  • Clinical Investigation
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Abstract

Purpose

To evaluate the clinical value of accessory hepatic vein (AHV) intervention in the treatment of Budd–Chiari syndrome (BCS).

Patients and Methods

From August 2008 to July 2014, consecutive patients with BCS caused by obstruction of three hepatic veins (HVs) with or without obstruction of inferior vena cava (IVC) were treated by recanalization or transjugular intrahepatic portosystemic shunt in our center. Patients who had the compensatory AHV and successfully underwent recanalization of AHV outflow were enrolled in this retrospective study. The clinical response to AHV drainage was analyzed.

Results

Compensatory AHV was found in 69 of 97 (71.1 %) patients, and 66 patients successfully underwent recanalization of AHV outflow (IVC recanalization, n = 49; AHV recanalization, n = 15; both, n = 2). In total, 78 AHVs were used instead of HV as the hepatic drainage vein after treatment. Fifty-five patients had one AHV, 10 patients had two AHVs, and 1 patient had three AHVs. The average diameter of all AHV stems was 8.0 ± 2.6 mm (range 5–21 mm). Clinical response to AHV drainage was positive in all patients. Patients’ symptoms and liver function improved progressively after treatment. During the follow-up of 3–74 months (average 39.4 ± 11.0 months), 11 patients experienced reobstruction at 6 to 36 months (average 16.8 ± 9.8 months) after treatment.

Conclusion

Compensatory AHV can be effectively used instead of HV for drainage of hepatic blood in patients with BCS. AHV intervention can help to simplify the BCS treatment procedure.

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Conflict of interest

All authors including Yu-Fei Fu, Ning Wei, Qian Wu, Qing-Qiao Zhang, Yan-Feng Cui, and Hao Xu of this study declare that they have no conflicts of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Author notes

    Authors and Affiliations

    1. Department of Radiology, Xuzhou Central Hospital, 199 Jie-fang Road, Xuzhou, Jiangsu, 221009, China

      Yu-Fei Fu

    2. Department of Interventional Radiology, Affiliated Hospital of Xuzhou Medical College, 99 West Huai-hai Road, Xuzhou, Jiangsu, 221006, China

      Ning Wei, Qing-Qiao Zhang, Yan-Feng Cui & Hao Xu

    3. Department of Nuclear Medicine, Xuzhou Central Hospital, 199 Jie-fang Road, Xuzhou, Jiangsu, 221009, China

      Qian Wu

    Authors
    1. Yu-Fei Fu
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    2. Ning Wei
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    3. Qian Wu
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    4. Qing-Qiao Zhang
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    5. Yan-Feng Cui
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    6. Hao Xu
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    Corresponding author

    Correspondence to Hao Xu.

    Additional information

    Yu-Fei Fu, Ning Wei, and Qian Wu have contributed equally to this study.

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    Fu, YF., Wei, N., Wu, Q. et al. Use of Accessory Hepatic Vein Intervention in the Treatment of Budd–Chiari Syndrome. Cardiovasc Intervent Radiol 38, 1508–1514 (2015). https://doi.org/10.1007/s00270-015-1105-4

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    • DOI: https://doi.org/10.1007/s00270-015-1105-4

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