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CardioVascular and Interventional Radiology

, Volume 42, Issue 9, pp 1311–1321 | Cite as

Interventional Treatment Strategy for Primary Budd–Chiari Syndrome with Both Inferior Vena Cava and Hepatic Vein Involvement: Patients from Two Centers in China

  • De-lei Cheng
  • Hao Xu
  • Cheng-li Li
  • Wei-fu Lv
  • Chuan-ting LiEmail author
  • Gauri Mukhiya
  • Wei-wei Fang
Clinical Investigation Venous Interventions
  • 99 Downloads
Part of the following topical collections:
  1. Venous Interventions

Abstract

Objective

This retrospective study evaluated interventional treatments (recanalization, balloon dilation, and/or stent placement) for Budd–Chiari syndrome (BCS), caused by combined obstruction of the inferior vena cava (IVC) and hepatic veins (HVs).

Methods

Before and after interventional therapy, patients with BCS (n = 162; asymptomatic 105.2 ± 103.3 mo; follow-up 15 [6–24] mo) underwent imaging studies (color Doppler ultrasound, CT, or MRI), and inferior vena cavography and manometry. Venous lesions were characterized by occlusion features, and presence of thrombosis and peripheral collateral vessels.

Results

One, 2, and 3 main HV occlusions were observed, respectively, in 25 (15.4%), 61 (37.7%), and 76 (46.9%) patients. Eighty-three (51.2%), 98 (60.5%), and 104 (64.2%) patients had, respectively, large accessory HVs, venous collaterals formed between the HVs, or venous communicating branches between the HV and the peritoneal veins. The middle, left, and right HV was patent in 32 (19.8%), 35 (21.6%), and 44 (27.2%) patients. Recanalization of both hepatic and caval occlusions was successful in 96% (51/53) of those attempted; recanalization of IVC occlusion was successful in 97% (106/109). Among 157 patients successfully treated, 146 were cured and 11 showed clinical improvement. Clinical symptoms were relieved in 82.4% after the initial intervention, and 94.2% after the second intervention.

Conclusion

Recanalization and balloon angioplasty was effective for the management of BCS with concurrent HV and IVC occlusions. The majority of patients required only IVC recanalization. The outcome of patients treated only by IVC intervention was similar to that of patients given combined HV and IVC intervention.

Keywords

Budd–Chiari syndrome Interventional treatment Hepatic veins Survival rate 

Abbreviations

BCS

Budd–Chiari syndrome

CI

Confidence interval

HV

Hepatic vein

IVC

Inferior vena cava

MRI

Magnetic resonance imaging

Notes

Acknowledgements

This project was supported by the Natural Science Foundation of Anhui Province (Grant No. 1708085QH218).

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures were performed in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent

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

Supplementary material

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Supplementary material 1 (DOCX 312 kb)
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Supplementary material 5 (DOCX 171 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  • De-lei Cheng
    • 1
    • 3
  • Hao Xu
    • 2
  • Cheng-li Li
    • 3
  • Wei-fu Lv
    • 1
  • Chuan-ting Li
    • 3
    Email author
  • Gauri Mukhiya
    • 4
  • Wei-wei Fang
    • 1
  1. 1.Department of Interventional Radiology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Division of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiPeople’s Republic of China
  2. 2.Department of Interventional RadiologyAffiliated Hospital of Xuzhou Medical UniversityXuzhouPeople’s Republic of China
  3. 3.Shandong Medical Imaging Research InstituteShandong UniversityJinanPeople’s Republic of China
  4. 4.Zhengzhou UniversityZhengzhouPeople’s Republic of China

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