Budd-Chiari Syndrome Caused by Obstruction of the Hepatic Inferior Vena Cava: Immediate and 2-Year Treatment Results of Transluminal Angioplasty and Metallic Stent Placement

Journal Article · Fri Nov 15 04:00:00 EST 1996 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S002709900006· OSTI ID:21080559

Ke, Xu; Fangxian, He; Hanguo, Zhang; Xitong, Zhang; Minjun, Han; Changrong, Wang ^[1]; Kaneko, Masao; Takahashi, Motoichiro; Okawada, Taketoshi ^[2]

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1. Department of Radiology, First Teaching Hospital of China Medical University, 155 Nanjing Bei St., Shenyang (China)
2. Department of Radiology, Hamamatsu Medical University, 3600 Handacho, Hamamatsu (Japan)

Purpose: To assess the usefulness of percutaneous transluminal angioplasty (PTA) and expandable metallic stent (EMS) placement for treatment of Budd-Chiari syndrome (BCS). Methods: Thirty-two patients with BCS were treated by PTA alone or by PTA and EMS placement. Among the 32 patients, a membranous obstruction was found in 24 and a segmental stenosis or occlusion in 8 patients. The follow-up period for PTA was 38<+>-<+>68 months (mean 52.2 months); for EMS it was 20<+>-<+>36 months (mean 24.3 months). Results: Twenty-one patients underwent PTA as the primary treatment. Of these, one patient died of disseminated intravascular coagulation shortly after the procedure; 20 had good to excellent initial angiographic and clinical results. Of the 20, restenosis or reocclusion developed in 10 patients (48%), all before 27 months; 8 patients (38%) became symptomatic, and 2 remained symptom-free for a total recurrent obstruction rate of 50%. The EMS group of 17 patients included 11 patients who underwent primary stenting and 6 patients with secondary stenting after recurrence following primary PTA; restenosis was demonstrated in only 2 patients (12%). Conclusions: We conclude that PTA alone produces excellent short-term results and about 50% sustained patency after 2 years in patients with BCS; therefore it should remain the procedure of first choice. Stents should be reserved for primary or secondary PTA failures.

• OSTI ID: 21080559
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 1 Vol. 19; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

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