Expandable venous stents for treatment of the Budd-Chiari syndrome.

Abstract

The goals of treatment of the Budd-Chiari syndrome are relief of portal hypertension, relief of inferior vena cava syndrome, if present, and preservation of hepatic function. This study presents a patient with clinical resolution of the Budd-Chiari syndrome after placement of expandable metallic stents in the inferior vena cava and hepatic veins. A 26-year-old man with severe ascites and lower extremity edema but with relatively preserved hepatic function had a small gradient across a suprahepatic caval web, large gradients across an intrahepatic caval stenosis and the left hepatic vein, and an occluded right hepatic vein. Under angiographic control, web and caval stenosis were balloon-dilated, and modified Gianturco expandable metallic stents were placed in the intrahepatic vena cava. The left hepatic vein was dilated twice and a stent was placed. All gradients were completely eliminated. There were no complications and after 1 year, the stents have fully expanded without migration, edema and ascites have resolved, hepatic function has normalized, and the patient has returned to work. This new technique provides a simple, safe, effective, relatively inexpensive, and potentially long-lasting treatment for selected patients with the Budd-Chiari syndrome.

• Authors: R R Lopez Jr, K G Benner, L Hall, J Rösch, C W Pinson
• Journal: Gastroenterology (Gastroenterology) Vol. 100 Issue 5 Pt 1 Pg. 1435-41 (May 1991) ISSN: 0016-5085 [Print] United States
• PMID: 1826488 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Angioplasty, Balloon
• Budd-Chiari Syndrome (therapy)
• Hepatic Veins (diagnostic imaging)
• Humans
• Male
• Radiography
• Stents
• Vena Cava, Inferior (diagnostic imaging)