Long-term efficacy of interventional treatment for Budd-Chiari syndrome with hepatic vein thrombosis

HAN Xing; HUANG Qianxin; ZHUANG Buqiang; SHEN Bin; YANG Jing; XU Hao; ZU Maoheng; ZHANG Qingqiao

Abstract：Objective To evaluate the long-term efficacy of interventional treatment for Budd Chiari syndrome(BCS)with hepatic vein thrombosis(HVT).Methods The clinical data of 39 BCS patients with HVT were selected.All 39 BCS patients with HVT were diagnosed through color Doppler ultrasound,DSA and transcatheter thrombus aspiration.Small balloon pre-dilation,transcatheter thrombolysis,balloon dilation and/or stent placement of hepatic vein were performed for treatment.Follow-up was performed by color Doppler ultrasound or MRA at 1,3,6,and 12 months after treatment,and annually thereafter.The cumulative primary patency rate of hepatic veins and the cumulative survival rate of patients were evaluated with Kaplan-Meier curves.Results Complete or partial thrombus dissolution was accomplished in 28 and 11 cases,respectively.The retaining time of transcatheter thrombolysis was 3-11(mean 5.3±3.8)days.All 39 patients achieved successful recanalization of the ob-structed HV.Among these patients,26 cases underwent balloon dilation and 13 cases underwent stent placement.No complica-tions of bleeding or pulmonary embolism occurred.Thirty-nine patients were followed up for 6-154(mean 82.2±43.4)months.There were no cases of thrombus recurrence.Fourteen cases experienced hepatic vein re-occlusion,which were successfully treated with balloon dilation.The cumulative 1,3,5,and 10 year primary hepatic vein patency rates were 79.5%,70.9%,60.19%,and 60.1%,revealed vascular.Seven patients died.The cumulative 1,3,5,and 10 year survival rates were 97.4%,94.9%,87.2%,and 82.1%,respectively.Conclusion Interventional treatment of BCS with HVT can achieve good long-term efficacy,but some patients still face the risk of re-occlusion and need to be closely followed up and managed.