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20.06.2017 | Original Article

Budd-Chiari syndrome: outcomes of endovascular intervention—A single-center experience

verfasst von: Nitin Jagtap, Mithun Sharma, Jagdeesh Singh, Manu Tandan, P N Rao, Rajesh Gupta, Sundeep Lakhtakia, Mohan Ramchandani, Harshal Shah, T Mahesh Kumar, Santosh Darishetty, G V Rao, D N Reddy

Erschienen in: Indian Journal of Gastroenterology | Ausgabe 3/2017

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Abstract

Aim

Outcomes of endovascular intervention in Budd-Chiari syndrome (BCS) have been reported with varied results. Clinical outcomes of endovascular interventions in BCS and role of various prognostic scores were critically evaluated in this study.

Methods

This study retrospectively analyzed consecutive patients of BCS who underwent endovascular intervention between January 2007 and May 2016 at our center. Technical, clinical successes and complications were documented. The role of the prognostic scores such as Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), Rotterdam index, and original Clichy score in predicting mortality, clinical success, and need for re-interventions were also assessed.

Results

A total of 88 patients were analyzed. The median follow up was 12 months (range 1–96 months). Thirteen (14.8%) patients had combined inferior vena cava (IVC) and hepatic vein (HV) obstruction; HV obstruction in 33 (37.5%) and inferior vena cava IVC obstruction in 42 (47.7%) patients. The following interventions were done: IVC angioplasty alone (n = 11), IVC angioplasty with stenting (n = 36), HV angioplasty with stenting (n = 26), combined HV and IVC stent (n = 2), and direct intrahepatic porto-systemic shunt (DIPS) (n = 13). Overall technical success was 87/88 (98.86%), and clinical success was 76/88 (86.36%). Immediate complications were noted in 8 patients (10%). The 1-, 2-, 3-, and 4-year stent patency rates were 90.91%, 81.08%, 74.59%, and 70.45%, respectively. Re-interventions were required in 15 (17%). Overall mortality was 6 (6.8%). Apart from MELD >14, none of the other prognostic score could predict mortality, clinical success, and need for re-interventions.

Conclusion

Endovascular interventions play an important role in the management of BCS, in properly selected patients, even if prognostic score is unfavorable.

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Titel: Budd-Chiari syndrome: outcomes of endovascular intervention—A single-center experience
verfasst von: Nitin Jagtap
Mithun Sharma
Jagdeesh Singh
Manu Tandan
P N Rao
Rajesh Gupta
Sundeep Lakhtakia
Mohan Ramchandani
Harshal Shah
T Mahesh Kumar
Santosh Darishetty
G V Rao
D N Reddy
Publikationsdatum: 20.06.2017
Verlag: Springer India
Erschienen in: Indian Journal of Gastroenterology / Ausgabe 3/2017
Print ISSN: 0254-8860
Elektronische ISSN: 0975-0711
DOI: https://doi.org/10.1007/s12664-017-0760-6

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