Objective To evaluate endovascular
treatment of
Budd-Chiari syndrome(BCS)with occlusion of
hepatic veins.
Methods Retrospective
analysis on the clinical materials of 32 BCS cases with occlusion of
hepatic veins was made.Four cases received
inferior vena cava(IVC)
angioplasty or
stent implant and
splenorenal shunt;Transfemoral
vein or transjugular
hepatic vein angioplasty was performed in 10 cases,and percutaneous transhepatic recanalization combined with transjugular and/or transfemoral
vein angioplasty of
hepatic veins was performed in 16 cases,respectively.Two cases failed
therapy attempt.Results A failure to find the main
hepatic vein in percutaneous transhepatic
venography lead to the abandent of
therapy in 2 cases.
Hepatic vein angioplasty and IVC
angioplasty was successful in the other 30 cases.The
pressure of
hepatic vein decreased from(43±8)cm H_2O to(16±4)cm H_2O(t=21.23,P<0.01).The symptoms were obviously relieved,
ascites disappeared,abdominal distension palliated,
chest and
abdominal wall varicose veins collapsed one week after endovascular
treatment.During perioperative
procedure,2 cases with
liver puncture bleeding were cured by
laparotomy.The follow-up duration was 5 months to 65 months and mean(26.0±2.0)months.There was no
stent migration and
hepatic vein restenosis and occlusion.
Chest and
abdominal wall varicose veins disappeared and
esophagus phlebeurysma were ameliorated as shown by esophageal
barium series.There were no
pulmonary embolism and
death.Conclusions The
procedure of endovascular
treatment of BCS with occlusion of
hepatic veins is simple,mini-traumatic and effective.