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  • Title: Budd-Chiari syndrome caused by obstruction of the hepatic inferior vena cava: immediate and 2-year treatment results of transluminal angioplasty and metallic stent placement.
    Author: Xu K, He FX, Zhang HG, Zhang XT, Han MJ, Wang CR, Kaneko M, Takahashi M, Okawada T.
    Journal: Cardiovasc Intervent Radiol; 1996; 19(1):32-6. PubMed ID: 8653743.
    Abstract:
    PURPOSE: To assess the usefulness of percutaneous transluminal angioplasty (PTA) and expandable metallic stent (EMS) placement for treatment of Budd-Chiari syndrome (BCS). METHODS: Thirty-two patients with BCS were treated by PTA alone or by PTA and EMS placement. Among the 32 patients, a membranous obstruction was found in 24 and a segmental stenosis or occlusion in 8 patients. The follow-up period for PTA was 38-68 months (mean 52.2 months); for EMS it was 20-36 months (mean 24.3 months). RESULTS: Twenty-one patients underwent PTA as the primary treatment. Of these, one patient died of disseminated intravascular coagulation shortly after the procedure; 20 had good to excellent initial angiographic and clinical results. Of the 20, restenosis or reocclusion developed in 10 patients (48%), all before 27 months; 8 patients (38%) became symptomatic, and 2 remained symptom-free for a total recurrent obstruction rate of 50%. The EMS group of 17 patients included 11 patients who underwent primary stenting and 6 patients with secondary stenting after recurrence following primary PTA; restenosis was demonstrated in only 2 patients (12%). CONCLUSIONS: We conclude that PTA alone produces excellent short-term results and about 50% sustained patency after 2 years in patients with BCS; therefore it should remain the procedure of first choice. Stents should be reserved for primary or secondary PTA failures.
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