Patients with
Budd-Chiari syndrome may require
therapy with portal decompressive surgery. Transjugular intrahepatic
portosystemic shunt has recently emerged as a new treatment alternative to surgical shunting, but reported literature is scarce and its long-term outcome is to be evaluated. The aim of our study was to present two patients with
Budd-Chiari syndrome treated with transjugular intrahepatic
portosystemic shunt. Two female patients with acute and subacute
Budd-Chiari syndrome respectively, uncontrolled by medical
therapy, were referred for transjugular intrahepatic portosystemic shunting. Both patients had refractory
ascites, while one had
hepatic insufficiency.
Hepatic vein thrombosis was without definitive etiology in one patient and due to essential
thrombocytosis in the other. Transjugular intrahepatic
portosystemic shunt was successfully created in both patients; in one a transcaval approach was performed. Bare
stents were used in one, while in the other a
polytetrafluoroethylene-covered
stent-graft. Technical success was 100% with no complications.
Ascites resolved in both patients and liver function improved. The first patient remains asymptomatic with good shunt patency 6 months after intervention. The second patient is symptom-free two years after the shunt creation, despite
stent occlusion. She remains asymptomatic due to hepatic vein collateral development. In patients with acute or subacute
Budd-Chiari syndrome uncontrolled by medical
therapy, transjugular intrahepatic
portosystemic shunt is highly effective with no complications and an associated mid-term clinical success.