Evaluation of the safety and efficacy of hepatic vein recanalization via intrahepatic collateral pathways in the treatment of Budd-Chiari syndrome with hepatic vein obstruction
MA Hongru
SHEN Bin
LIU Hongtao
XIAO Jinchang
WANG Wenliang
WEI Ning
GAO Zhikang
XU Hao
ZU Maoheng
ZHANG Qingqiao
Abstract：Objective To evaluate the safety and efficacy of hepatic vein(HV)recanalization using intrahepatic collateral pathways in patients with Budd-Chiari syndrome(BCS)with HV obstruction.Methods Data from 21 BCS patients with HV obstruction treated at our hospital were analyzed.All patients underwent HV recanalization through intrahepatic collateral path-ways.The pressure of HV and inferior vena cava was measured before and after treatment.The efficacy and complications were observed.Follow-up was performed at 1,3,6,and 12 months after treatment and annually thereafter,HV patency was assessed using color Doppler ultrasound.The pressure gradient of HV-inferior vena cava before and after treatment was compared with paired t test.Results All 21 patients achieved successful recanalization of the obstructed HVs through intrahepatic collateral pathways.Among the 21 patients,one HV was successfully recanalized in 9 patients,two HVs were successfully recanalized in 10 patients,and three HVs were successfully recanalized in 2 patients.The mean pressure gradient of HV-inferior vena cava de-creased from(14.5±2.7)mmHg before treatment to(6.7±1.3)mmHg after treatment(t=11.789;P<0.01).There were no com-plications of HV rupture and pericardial tamponade during or after the treatment.Over the follow-up period of 8 to 31(mean 23.2±5.3)months after interventional treatment of the 21 patients,reocclusion of HV was found in 3 patients.The overall cumulative 6-,12-,and 24-month primary patency rates were 100%,95.2%,and 85.7%,respectively.Conclusion Interventional treat-ment of HV obstruction in BCS patients through intrahepatic collateral approaches is safe and effective,with reliable midterm ef-ficacy,providing a new option for patients with HV obstruction in BCS.
Keywords：Budd-Chiari syndromeHepatic vein obstructionIntrahepatic collateral pathwayInterventionalRadiology
Publication Date：2024-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 64-67 )