The Usefullness of Percutaneous Transluminal Balloon Angioplasty in the Management of Budd-Chiari Syndrome.
- Author:
Se Hwan KIM
1
;
Kyung Sool YU
;
Seung Min BAEK
;
Seung Yup LEE
;
Hyun Su KIM
;
Won Young TAK
;
Young Oh KWEON
;
Sung Kook KIM
;
Yong Hwan CHOI
;
Joon Mo CHUNG
Author Information
1. Department of Internal Medicine, Fatima Hospital, Daegu, Korea. khsmhj@medigate.net
- Publication Type:Original Article ; English Abstract
- Keywords:
Budd-Chiari Syndrome;
Percutaneous Transluminal Balloon Angioplasty
- MeSH:
Adult;
Aged;
*Angioplasty, Balloon;
English Abstract;
Female;
Hepatic Vein Thrombosis/complications/diagnosis/*therapy;
*Hepatic Veins;
Human;
Male;
Middle Aged;
*Vena Cava, Inferior
- From:The Korean Journal of Hepatology
2002;8(2):179-199
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Membranous obstruction is the most common cause of Budd-Chiari syndrome in Orientals. Recently, percutaneous transluminal balloon angioplasty (PTBA) has been successfully applied as a treatment of membranous obstruction. We evaluated etiologies and clinical manifestations in our cases and the usefulness of PTBA. METHODS: Twelve cases of Budd-Chiari syndrome were analyzed. RESULTS: 50.3 years was the average age of the cases (ranging from 37 to 67 years). Major symptoms or signs were superficial collateral vessels on the chest or the abdomen in 6 cases, ascites in 3, abdominal pain in 4, hepatomegaly in 4, splenomegaly in 3, melena or hematemesis in 2, and leg edema in 2. Upper gastrointestinal endoscopy showed esophageal varices in 6 cases and two of these 6 cases had gastric varices. Of 8 cases with liver cirrhosis, 4 were classified as Child-Pugh class A and 4 as B. Four patients with cirrhosis had concurrent hepatocellular carcinoma including 1 patient who was HBs Ag positive. Etiologies were membranous obstruction in 11 cases and protein C deficiency in 1 case. The main site of obstruction was IVC in 8 and hepatic vein in 4. PTBA was successfully performed in 8 cases of membranous obstruction. During the mean follow-up period of 27.6 months (12-40 months), there were no reobstructions except in 2 cases. CONCLUSIONS: The most common cause of Budd-Chiari syndrome in our cases was membranous obstruction of IVC. Percutaneous transluminal balloon angioplasty is a very useful treatment method.
