Budd-Chiari syndrome due to prothrombotic disorder: mid-term patency and efficacy of endovascular stents.
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.
Pelage
Jean-Pierre
JP
Department of Radiology, Hôpital Beaujon, AP-HP, 100 Boulevard du Général Leclerc, 92110 Clichy, France.
Denys
Alban
A
Valla
Dominique
D
Sibert
Annie
A
Sauvanet
Alain
A
Belghiti
Jacques
J
Menu
Yves
Y
D000328:Adult; D000800:Angioplasty, Balloon / Q000295:instrumentation; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006504:Hepatic Veno-Occlusive Disease / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D008875:Middle Aged; D010690:Phlebography; D012008:Recurrence; D015607:Stents; D019851:Thrombophilia / Q000000981:diagnostic imaging / Q000628:therapy*; D014654:Vascular Patency; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging