title: [Management of difficult, severe and recurrent Budd-Chiari syndrome].
abstract: OBJECTIVE
  To investigate the management of complicated, severe or recurrent Budd-Chiari syndrome.
  
  
  METHODS
  From February 2004 to August 2007, 28 patients with complicated, severe or recurrent Budd-Chiari syndrome were treated. In this series, 16 patients relapsed after treated with percutaneous transluminal angioplasty or stent deployment, 2 cases relapsed after surgery; and the other 10 were under severe conditions and hard to treat, including malignancy of the inferior vena cava and right atrium. Meso-cavo-atrial shunt was carried out in 10 cases, meso-cavo-jugular shunt in 6 (capitis medusa was used in one case), cavoatrial shunt in 2 and cavo-jugular shunt in 1, mesocaval shunt in 2, and radical or extended radical correction in 7.
  
  
  RESULTS
  One patient (3.6%) died in 24 hours after operation. Graft infection occurred in 1 case. Excellent, good, fair, poor and death rate were 22.2%, 55.5%, 14.8%, 3.7% and 3.7%, respectively, the overall effective rate was 92.5%.
  
  
  CONCLUSIONS
  To select personalized treatment according to the disease status brings hopes to difficult, severe, recurrent Budd-Chiari syndrome.
authors.affiliation: Department of Vascular Surgery, Xuanwu Hospital, the Capital Medical University, Beijing 100053, China. zhonggaowang@yahoo.com
authors.forename: Zhong-gao
authors.initials: ZG
authors.lastname: Wang
authors.forename: Chun-min
authors.initials: CM
authors.lastname: Li
authors.forename: Yong-quan
authors.initials: YQ
authors.lastname: Gu
authors.forename: Heng-xi
authors.initials: HX
authors.lastname: Yu
authors.forename: Bing
authors.initials: B
authors.lastname: Chen
authors.forename: Lian-rui
authors.initials: LR
authors.lastname: Guo
authors.forename: Xue-feng
authors.initials: XF
authors.lastname: Li
authors.forename: Shi-jun
authors.initials: SJ
authors.lastname: Cui
authors.forename: Zhen
authors.initials: Z
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D019917:Blood Vessel Prosthesis Implantation; D006502:Budd-Chiari Syndrome / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome