Percutaneous recanalization for Budd-Chiari syndrome: long-term outcomes in 141 Chinese patients

WANG Qiao-zheng1; ZHANG Wei2; CHEN Xiao-wei1; XU Ke1

doi:10.12117/jccmi.2019.08.014

Journal of China Clinic Medical Imaging ›› 2019, Vol. 30 ›› Issue (8) : 586-590. DOI: 10.12117/jccmi.2019.08.014

WANG Qiao-zheng1, ZHANG Wei2, CHEN Xiao-wei1, XU Ke1

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Abstract

Objective: To assess the long-term outcome of percutaneous recanalization in a large case series of patients with Budd-Chiari syndrome(BCS). Methods: Between July 1988 and August 2013, 161 consecutive Chinese patients with BCS were treated with percutaneous recanalization. Cumulative survival rates were assessed by Kaplan-Meier method, and independent predictors of survival were calculated with the Cox regression model. Results: Percutaneous recanalization was technically successful in 153 of the 161 patients(95%). Two patients died 16 h and 72 h respectively after operation because of disseminated intravascular coagulation(DIC) and severe hemoptysis, respectively. One hundred and forty-one out of the remaining 153 patients with BCS were successfully followed up. Patients with stent placement had a similar rate of reocclusion with those with percutaneous angioplasty(PTA) alone(P>0.1). Among 85 patients in patency group, as compared to 56 patients in reocclusion group, 6 versus 26 died: 0 versus 12 of liver failure, 0 versus 8 of variceal bleeding, and 6 versus 6 of reocclusion-unrelated diseases. Reocclusion was associated with a shorter survival(P<0.001). Out of 56 patients experiencing reocclusion, thirty received further intervention. Eight of these thirty patients had died of liver failure(n=2), neoplasm(n=4), and other fatal reocclusion-unrelated diseases(n=2). Conclusion: In patients with BCS treated with percutaneous recanalization, stent placement should be cautious for its similar reocclusion rate with PTA alone, and reocclusion has a major impact on morbidity and mortality. For patients experiencing reocclusion, revision of reocclusion is recommended for its corresponding prognosis improvement.

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Hepatic vein thrombosis / Radiology, interventional

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WANG Qiao-zheng1, ZHANG Wei2, CHEN Xiao-wei1, XU Ke1. Percutaneous recanalization for Budd-Chiari syndrome: long-term outcomes in 141 Chinese patients[J]. Journal of China Clinic Medical Imaging. 2019, 30(8): 586-590 https://doi.org/10.12117/jccmi.2019.08.014

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