Yu Fei Fu1, Hao Xu, Ke Zhang, Qing Qiao Zhang, Ning Wei. 1. Department of Interventional Radiology, The Affiliated Hospital of Xuzhou Medical College, Jiangsu, China. weiningjieru@163.com.
Abstract
PURPOSE: We aimed to investigate the feasibility and effectiveness of accessory hepatic vein recanalization (balloon dilatation/stent insertion) for patients with Budd-Chiari syndrome (BCS) due to long-segment obstruction of the hepatic vein. METHODS: From March 2010 to December 2013, 20 consecutive patients with BCS, due to long-segment obstruction of three hepatic veins, treated with accessory hepatic vein recanalization (11 males, 9 females; mean age, 33.4±10.9 years; range, 22-56 years) were included in this retrospective study. Data on technical success, clinical success, and follow-up were collected and analyzed. RESULTS: Technical and clinical success was achieved in all patients. Each patient was managed with a single accessory hepatic vein recanalization procedure. No procedure-related complications occurred. The diameter of the accessory hepatic vein was 8.45±1.47 mm (6-11 mm) at the stem, and there were many collateral circulations between the hepatic vein and the accessory hepatic vein. The mean pressure of accessory hepatic vein decreased from 47.50±5.59 cm H2O before treatment to 28.80±3.47 cm H2O after treatment (P < 0.001). Abnormal levels of total bilirubin, albumin, aspartate aminotransferase, and alanine transaminase improved after the treatment. During the follow-up, three patients experienced restenosis or stenting of the accessory hepatic vein. CONCLUSIONS: In BCS due to long-segment obstruction of the hepatic veins, it is important to confirm whether there is a compensatory accessory hepatic vein. For patients with a compensatory but obstructed accessory hepatic vein, recanalization is a simple, safe, and effective treatment option.
PURPOSE: We aimed to investigate the feasibility and effectiveness of accessory hepatic vein recanalization (balloon dilatation/stent insertion) for patients with Budd-Chiari syndrome (BCS) due to long-segment obstruction of the hepatic vein. METHODS: From March 2010 to December 2013, 20 consecutive patients with BCS, due to long-segment obstruction of three hepatic veins, treated with accessory hepatic vein recanalization (11 males, 9 females; mean age, 33.4±10.9 years; range, 22-56 years) were included in this retrospective study. Data on technical success, clinical success, and follow-up were collected and analyzed. RESULTS: Technical and clinical success was achieved in all patients. Each patient was managed with a single accessory hepatic vein recanalization procedure. No procedure-related complications occurred. The diameter of the accessory hepatic vein was 8.45±1.47 mm (6-11 mm) at the stem, and there were many collateral circulations between the hepatic vein and the accessory hepatic vein. The mean pressure of accessory hepatic vein decreased from 47.50±5.59 cm H2O before treatment to 28.80±3.47 cm H2O after treatment (P < 0.001). Abnormal levels of total bilirubin, albumin, aspartate aminotransferase, and alanine transaminase improved after the treatment. During the follow-up, three patients experienced restenosis or stenting of the accessory hepatic vein. CONCLUSIONS: In BCS due to long-segment obstruction of the hepatic veins, it is important to confirm whether there is a compensatory accessory hepatic vein. For patients with a compensatory but obstructed accessory hepatic vein, recanalization is a simple, safe, and effective treatment option.
Authors: Thomas Mammen; Shyamkumar Keshava; C E Eapen; Vinu Moses; N R S Surendra Babu; George Kurien; George Chandy Journal: J Vasc Interv Radiol Date: 2010-05-26 Impact factor: 3.464
Authors: Anders Bay Neumann; Stine Degn Andersen; Dennis Tønner Nielsen; Peter Holland-Fischer; Hendrik Vilstrup; Henning Grønbæk Journal: World J Hepatol Date: 2013-01-27