title: Transjugular intrahepatic portosystemic shunt for the treatment of Budd-Chiari syndrome patients: results from a single center.
abstract: OBJECTIVE
  To evaluate the outcome of transjugular intrahepatic portosystemic shunt (TIPS) in patients with Budd-Chiari syndrome (BCS).
  
  
  METHODS
  Fourteen patients (11 female, mean age 45.8 years), with symptomatic BCS refractory to conventional therapy, were treated with TIPS placement in our department within a period of 9 years. Stent grafts were primarily used in 12 patients. Mean follow-up time was 38.1 ± 36.1 months (range 7-114). Model for end-stage liver disease (MELD) score, BCS Rotterdam index, and Child-Pugh score were calculated for all patients. In addition, the recently suggested BCS-TIPS prognostic index score (BSC-TIPS PI) was applied.
  
  
  RESULTS
  BCS-TIPS PI score was ≤7 in all patients. Most of our patients (12 of 14) had good or intermediate prognosis according to MELD, Rotterdam and Child-Pugh scores. Technical success was achieved in all 14 patients and was accompanied by complete resolution of the symptoms. In 3 patients, the procedure was complicated by hemoperitoneum, which was successfully treated in two patients with coils or stent-graft placement, whereas 1 patient was managed in the operating room. Thirteen patients are symptom and orthotopic liver transplantation-free. Primary patency was 92.8, 84.7, and 58.7 % at 6, 12, and 24 months, respectively. Secondary patency was 100, 100 and 84.6 % at 6, 12, and 24 months respectively.
  
  
  CONCLUSIONS
  In symptomatic BCS patients with moderate prognosis according to MELD, Child-Pugh, and BCS Rotterdam scores, as well as BCS-TIPS PI score ≤7, TIPS has high clinical success, low morbidity, and no mortality, and it offers durable mid-term resolution of the symptoms and OLT-free survival.
authors.affiliation: 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 1, Rimini St, 12462, Athens, Greece, katerina_fi@yahoo.com.
authors.forename: Katerina
authors.initials: K
authors.lastname: Fitsiori
authors.forename: Maria
authors.initials: M
authors.lastname: Tsitskari
authors.forename: Alexios
authors.initials: A
authors.lastname: Kelekis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Filippiadis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Triantafyllou
authors.forename: Elias
authors.initials: E
authors.lastname: Brountzos
mesh_terms: D000328:Adult; D006502:Budd-Chiari Syndrome / Q000175:diagnosis / Q000601:surgery*; D003952:Diagnostic Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011379:Prognosis; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency