Interventional treatment of Budd-Chiari syndrome (A report of 143 cases)
- VernacularTitle:布加氏综合征的介入治疗(143例经验总结)
- Author:
Xiaoming ZHANG
;
Zhonggao WANG
;
Xuemin ZHANG
;
Wei LI
;
Qingyue LI
;
Jingjun JIANG
;
Yang JIAO
;
- Publication Type:Journal Article
- Keywords:
Budd-Chiari syndrome Stent Inferior vena cava(IVC)
- From:
Chinese Journal of Minimally Invasive Surgery
2001;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To sum up our clinical experience in interventional treatment of 143 cases of Budd-Chiari syndrome. Methods This study included 92 males and 51 females, aged from 6 to 65 years old with an average of 34.8 years. The pathologic types were composed of complete occlusion of inferior vena cava (IVC) (71), IVC stenosis (36), IVC membrane occlusion with a hole (29), membrane occlusion of hepatic vein (HV) (3), IVC thrombosis (4), and IVC lesions forementioned combined with HV occlusion (14). Therapeutic methods included that I: Percutaneous transinferior vena cava membranotomy and occlusion dilatation (PTA) (77); II: IVC PTA with stent (62); III: Percutaneous transhepatic vein recanalization (3); IV: IVC thrombolysis through a catheter (4); V: Additional operation after intervention (16). Results The range of reduced IVC pressure was (3 ～ 29) cmH 2O with the mean pressure being 12.1 cmH 2O. Complications occurred in 8 cases, including pulmonary embolism (PE), stent migration and HV occlusion after IVC stent (2 cases respectively), cardiac tamponade and hemothorax (1 case repectively). 2 cases died of PE and 3 cases died of hepatic coma after meso-caval shunt,the death rate being 3 5% . A follow-up study showed the recurrence rates were 10.4% in IVC PTA cases and 1.6% in IVC PTA with stent cases respectively, and no recurrence was found in other cases. Conclusions ① PTA is the first choice for localized lesions without fresh thrombus. ② For those with elastic recoil or recurrence, stent is suggested. ③ For those with both IVC lesions and HV occlusion, the additional operation to reduce portal hypertension is needed after IVC intervention.
