An Individualised Strategy and Long-Term Outcomes of Endovascular Treatment of Budd-Chiari Syndrome Complicated by Inferior Vena Cava Thrombosis.

Abstract

OBJECTIVES:

The aim was to evaluate individualised treatment and long-term outcomes of endovascular treatment of Budd-Chiari syndrome (BCS) complicated by inferior vena cava (IVC) thrombosis.

METHODS:

Between April 2005 and December 2015, 108 consecutive patients with BCS complicated by IVC thrombosis underwent endovascular treatment. According to the type, size, extent, and degree of organisation of the thrombus, agitation thrombolysis (n = 7), agitation thrombolysis combined with retrieval stent filter (n = 5), pre-dilation (n = 32), retrieval stent filter (n = 56), or direct large balloon dilation (n = 8) was performed. Peri- and post-operative follow-up data were recorded.

RESULTS:

The endovascular treatment was technically successful in 107 of the 108 patients (99.1%). The incidence of thrombosis related complications was 7.4% (8/108). Major and minor complications occurred in four patients. The mean follow-up duration was 61.7 ± 39.3 months (range 3-140 months). The cumulative 1, 2, 5, and 10 year primary patency rates were 91%, 88%, 79%, and 79%, respectively, and the cumulative 1, 2, 5, and 10 year secondary patency rates were 100%, 100%, 97%, and 97%, respectively. The cumulative 1, 5, and 10 year survival rates were 95%, 86%, and 81%, respectively. Serum albumin and total bilirubin values were independent predictors of survival.

CONCLUSIONS:

For patients with BCS complicated by IVC thrombosis, an individualised endovascular treatment strategy based on the type, size, extent, and degree of organisation of the thrombus is associated with long-term patency of the IVC and favourable survival and complication rates.

• Authors: P-X Ding, X He, X-W Han, Y Zhang, Y Wu, X-X Liang, C Liu
• Journal: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (Eur J Vasc Endovasc Surg) Vol. 55 Issue 4 Pg. 545-553 (04 2018) ISSN: 1532-2165 [Electronic] England
• PMID: 29478911 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

Topics

• Adult
• Aged
• Budd-Chiari Syndrome (diagnostic imaging, physiopathology, surgery)
• Computed Tomography Angiography
• Endovascular Procedures (adverse effects, instrumentation)
• Female
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Phlebography (methods)
• Retrospective Studies
• Risk Factors
• Severity of Illness Index
• Time Factors
• Treatment Outcome
• Ultrasonography, Doppler, Color
• Vascular Patency
• Vena Cava, Inferior (diagnostic imaging, physiopathology, surgery)
• Venous Thrombosis (diagnostic imaging, physiopathology, surgery)