title: Treatment of Budd-Chiari syndrome with inferior vena cava thrombosis.
abstract: The aim of this study was to evaluate the initial results of 41 patients with Budd-Chiari syndrome (BCS) with inferior vena cava (IVC) thrombosis, with regard to the clinical safety and feasibility of the therapeutic approaches selected according to the classification of the condition. Forty-one patients with BCS and IVC thrombosis were admitted for retrospective analysis. All 41 patients were classified as having one of three types of BCS. Interventional therapy was used successfully in 28 patients (68.3%), 7 patients (17.1%) were given conservative treatment and 6 patients (14.6%) were treated with surgical shunts. The interventional approach was used in 29 patients in total and was successful in 28 patients (all those of types I and II, and 3 of the 4 patients of type III with acute thrombosis; 96.6%). None of these 28 patients had pulmonary embolism, pericardial tamponade or intra-abdominal bleeding. After 1-5 years, 4 patients (9.8%) had a second dilation of the IVC. In the 7 cases treated in a conservative manner, 2 cases succumbed to upper gastrointestinal bleeding and 1 case succumbed to liver and kidney failure. This study indicates that the classification of BCS patients with IVC thrombosis is helpful in selecting a therapeutic approach. Interventional therapy is the first therapeutic choice for BCS patients with IVC thrombosis of type I, type II or type III with acute thrombosis. For the patients of type III with an obsolete thrombus, surgical shunts or conservative treatment are the main therapeutic methods.
authors.affiliation: Department of Vascular Surgery, Jinan Central Hospital, Shandong University, Jinan 250021, P.R. China ; Department of Vascular Surgery, Shandong Provincial Hospital, Shandong University, Jinan 250021, P.R. China.
authors.forename: Ruihua
authors.initials: R
authors.lastname: Wang
authors.forename: Qingyi
authors.initials: Q
authors.lastname: Meng
authors.forename: Lifeng
authors.initials: L
authors.lastname: Qu
authors.forename: Xuejun
authors.initials: X
authors.lastname: Wu
authors.forename: Nianfeng
authors.initials: N
authors.lastname: Sun
authors.forename: Xing
authors.initials: X
authors.lastname: Jin
keywords: Budd-Chiari syndrome; classification; inferior vena cava; thrombosis