Our objective was to evaluate efficacy and patency of metallic
stent placement for symptomatic
Budd-Chiari syndrome (BCS) due to prothrombotic disorders. Eleven patients with proved BCS due to prothrombotic disorders were referred for endovascular treatment because of refractory
ascites (n=9),
abdominal pain (n=8),
jaundice (n=6), and/or gastrointestinal
bleeding (n=4).
Stents were inserted for stenosed hepatic vein (n=7), inferior vena cava (n=2), or mesenterico-caval shunt (n=2). Clinical efficacy and
stent patency was evaluated by clinical and Doppler follow-up. After a mean follow-up of 21 months, 6 patients had fully patent
stents without reintervention (primary
stent patency: 55%). Two patients with hepatic vein
stenosis had
stent thrombosis and died 4 months after procedure. Restenosis occurred in 3 cases (2 hepatic vein and 1 mesenterico-caval shunt
stenosis) and were successfully treated by balloon angioplasty (n=2) and addition of new
stents (n=1) leading to a 82% secondary
stent patency. Of 9 patients with patent
stent, 7 were asymptomatic (77%) at the end of the study.
Stent placement is a safe and effective procedure to control of symptomatic BCS. Prothrombotic disorder does not seem to jeopardize patency in anticoagulated patients.