Hepatology International

, Volume 10, Issue 2, pp 363–369 | Cite as

Percutaneous recanalization for hepatic vein-type Budd-Chiari syndrome: long-term patency and survival

  • Yan-Feng Cui
  • Yu-Fei Fu
  • De-Chun Li
  • Hao XuEmail author
Original Article



To determine the long-term patency and survival of percutaneous recanalization for hepatic vein (HV)-type Budd-Chiari syndrome (BCS).


From March 2009 to November 2014, consecutive symptomatic HV-type BCS patients were treated by percutaneous recanalization in our centers. These patients underwent main HV (MHV) or accessory HV (AHV) recanalization. Data on patient characteristics, technical success, clinical success, long-term patency, and survival were collected and analyzed.


During the enrolled periods, a total of 143 symptomatic HV-type BCS patients were treated by percutaneous recanalization in our centers. Technical success was achieved in 140 of 143 patients. One hundred eleven patients underwent MHV recanalization, and 29 underwent AHV recanalization. Clinical success was achieved in 136 of 140 patients. The mean MHV/AHV pressure decreased from 33.5 ± 4.1 mmHg before treatment to 12.5 ± 3.1 mmHg after treatment (p = 0.000). The 136 patients were followed for 7–75 months (mean 33.9 ± 15.3 months). Twenty-eight patients experienced re-obstruction of MHV (n = 24) or AHV (n = 4) at 3 to 36 months (mean 18.0 ± 11.5 months) after treatment. The cumulative 1-, 3-, and 6-year primary patency rates were 91.1, 77.4, and 74.0 %, respectively. The cumulative 1-, 3-, and 6-year secondary patency rates were 97.0, 92.4, and 88.8 %, respectively. The cumulative 1-, 3-, and 6-year survival rates were 97.7, 92.2, and 90.0 %, respectively.


Percutaneous recanalization can provide good long-term patency and survival in HV-type BCS patients.


Hepatic vein Budd-Chiari syndrome Percutaneous recanalization Long-term outcomes 


Compliance with ethical standards

Conflicts of interest

Yan-Feng Cui, Yu-Fei Fu, De-Chun Li, and Hao Xu declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. This article does not contain any studies with animals performed by any of the authors. This was a retrospective study approved by our Institutional Review Board. Each patient received the details about percutaneous recanalization and provided written informed consent for percutaneous recanalization before treatment.

Informed consent

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


  1. 1.
    Zhang CQ, Fu LN, Xu L, Zhang GQ, Jia T, Liu JY, et al. Long-term effect of stent placement in 115 patients with Budd-Chiari syndrome. World J Gastroenterol. 2003;9:2587–91.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Zhang QQ, Xu H, Zu MH, Gu YM, Shen B, Wei N, et al. Strategy and long-term outcomes of endovascular treatment for Budd-Chiari syndrome complicated by inferior vena caval thrombosis. Eur J Vasc Endovasc Surg. 2014;47:550–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Sun J, Zhang Q, Xu H, Huang Q, Shen B, Zu M, et al. Clinical outcomes of warfarin anticoagulation after balloon dilation alone for the treatment of Budd-Chiari syndrome complicated by old inferior vena cava thrombosis. Ann Vasc Surg. 2014;28:1862–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Fu YF, Xu H, Wu Q, Zhang QQ, Cui YF, Wei N. Combined thrombus aspiration and recanalization in treating Budd-Chiari syndrome with inferior vena cava thrombosis. Radiol Med. 2015;. doi: 10.1007/s11547-015-0554-9 (Epub 2015 May 24).Google Scholar
  5. 5.
    Han G, Qi X, Zhang W, He C, Yin Z, Wang J, et al. Percutaneous recanalization for Budd-Chiari syndrome: an 11-year retrospective study on patency and survival in 177 Chinese patients from a single center. Radiology. 2011;266:657–67.CrossRefGoogle Scholar
  6. 6.
    Fu YF, Li Y, Cui YF, Wei N, Li DC, Xu H. Percutaneous recanalization for combined-type Budd-Chiari syndrome: strategy and long-term outcome. Abdom Imaging. 2015;. doi: 10.1007/s00261-015-0496-7 (Epub 2015 Jun 30).Google Scholar
  7. 7.
    Cui YF, Fu YF, Wei N, Zhu HC, Xu H. Retrograde puncture assisted hepatic vein recanalization in treating Budd-Chiari syndrome with segmental obstruction of hepatic vein. Radiol Med. 2015;. doi: 10.1007/s11547-015-0557-6 (Epub 2015 Jun 7).Google Scholar
  8. 8.
    Tripathi D, Macnicholas R, Kothari C, Sunderraj L, Al-Hilou H, Rangarajan B, et al. Good clinical outcomes following transjugular intrahepatic portosystemic stent-shunts in Budd-Chiari syndrome. Aliment Pharmacol Ther. 2014;39:864–72.CrossRefPubMedGoogle Scholar
  9. 9.
    Fu YF, Wei N, Wu Q, Zhang QQ, Cui YF, Xu H. Use of accessory hepatic vein intervention in the treatment of Budd-Chiari syndrome. Cardiovasc Intervent Radiol. 2015;. doi: 10.1007/s00270-015-1105-4 (Epub 2015 Apr 23).Google Scholar
  10. 10.
    Tang W, Zhang XM, Yang L, Mitchell DG, Zeng NL, Zhai ZH. Hepatic caudate vein in Budd-Chiari syndrome: depiction by using magnetic resonance imaging. Eur J Radiol. 2011;77:143–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Mammen T, Keshava S, Eapen CE, Moses V, Babu NR, Kurien G, et al. Intrahepatic collateral recanalization in symptomatic Budd-Chiari syndrome: a single-center experience. J Vasc Interv Radiol. 2010;21:1119–24.CrossRefPubMedGoogle Scholar
  12. 12.
    Sang HF, Li XQ. Endovascular treatment of Budd-Chiari syndrome with hepatic vein obstruction in China. J Laparoendosc Adv Surg Tech A. 2014;24:846–51.CrossRefPubMedGoogle Scholar
  13. 13.
    Ding PX, Zhang SJ, Li Z, Fu MT, Hua ZH, Zhang WG. Long-term safety and outcome of percutaneous transhepatic venous balloon angioplasty for Budd-Chiari syndrome. J Gastroenterol Hepatol. 2015;. doi: 10.1111/jgh.13025 (Epub 2015 Jun 23).Google Scholar
  14. 14.
    Zahn A, Gotthardt D, Weiss KH, Richter G, Schmidt J, Stremmel W, et al. Budd-Chiari Syndrome: Long term success via hepatic decompression using transjugular intrahepatic porto-systemic shunt. BMC Gastroenterol. 2010;10:25.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Darwish Murad S, Plessier A, Hernandez-Guerra M, Fabris F, Eapen CE, Bahr MJ, et al. Etiology, management, and outcome of the Budd-Chiari syndrome. Ann Intern Med. 2009;151:167–75.CrossRefPubMedGoogle Scholar
  16. 16.
    Seijo S, Plessier A, Hoekstra J, Dell’era A, Mandair D, Rifai K, et al. Good long-term outcome of Budd-Chiari syndrome with a step-wise management. Hepatology. 2013;57:1962–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Qi X, Guo W, He C, Zhang W, Wu F, Yin Z, et al. Transjugular intrahepatic portosystemic shunt for Budd-Chiari syndrome: techniques, indications and results on 51 Chinese patients from a single centre. Liver Int. 2014;34:1164–75.CrossRefPubMedGoogle Scholar
  18. 18.
    Eapen CE, Velissaris D, Heydtmann M, Gunson B, Olliff S, Elias E. Favourable medium term outcome following hepatic vein recanalisation and/or transjugular intrahepatic portosystemic shunt for Budd Chiari syndrome. Gut. 2006;55:878–84.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Cheng D, Xu H, Lu ZJ, Hua R, Qiu H, Du H, Xu X, et al. Clinical features and etiology of Budd-Chiari syndrome in Chinese patients: a single-center study. J Gastroenterol Hepatol. 2013;28:1061–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Valla D, Hadengue A, el Younsi M, Azar N, Zeitoun G, Boudet MJ, et al. Hepatic venous outflow block caused by short-length hepatic vein stenoses. Hepatology. 1997;25:814–9.CrossRefPubMedGoogle Scholar

Copyright information

© Asian Pacific Association for the Study of the Liver 2015

Authors and Affiliations

  1. 1.Department of Interventional RadiologyThe Affiliated Hospital of Xuzhou Medical CollegeXuzhouChina
  2. 2.Department of RadiologyXuzhou Central HospitalXuzhouChina

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