期刊
LIVER INTERNATIONAL
卷 37, 期 1, 页码 111-120出版社
WILEY-BLACKWELL
DOI: 10.1111/liv.13180
关键词
ascites; liver; portal hypertension; radiology/imaging
Background & Aims: A proportion of patients with Budd-Chiari Syndrome (BCS) associated with stenosis or short occlusion of the hepatic vein (HV) or upper inferior vena cava (IVC) can be treated with recanalization by percutaneous venoplasty +/- HV stent insertion. We studied the long-term outcomes of this approach. Methods: Single-centre retrospective analysis of patients referred for radiological assessment +/- intervention over a 27-year period. Of 155 BCS patients, 63 patients who underwent venoplasty were studied and compared to a previously reported series treated by TIPSS (n = 59). Results: Patients treated with HV interventions (32 venoplasty alone, 31 endovascular stents): mean age, 34.9 +/- 10.9; M:F ratio 27: 36; median follow-up, 113.0 months; 62% of patients had >= 1 haematological risk factor. Technical success was 100%, with symptom resolution in 73%. Cumulative secondary patency at 1, 5, 10 years was 92%, 79%, 79% and 69%, 69%, 64% in the stenting and venoplasty groups respectively. Where long-term patency was not achieved, 10 patients required TIPSS, and 8 underwent surgery. Actuarial survival at 1, 5, 10 years was 97%, 89% and 85%. When compared to TIPSS, HV interventions resulted in similar patency and survival rates but significantly lower procedural complications (9.5% vs 27.1%) and hepatic encephalopathy (0% vs 18%). Patient age predicted survival following multivariate analysis. Conclusions: Our data support the stepwise approach to management of BCS, with very good outcomes from venoplasty combined with stenting when required. TIPSS should only be offered where HV interventions are not feasible or unsuccessful.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据