title: Accessory hepatic vein recanalization for treatment of Budd-Chiari syndrome due to long-segment obstruction of the hepatic vein: initial clinical experience.
abstract: OBJECTIVE
  We aimed to investigate the feasibility and effectiveness of accessory hepatic vein recanalization (balloon dilatation/stent insertion) for patients with Budd-Chiari syndrome (BCS) due to long-segment obstruction of the hepatic vein.
  
  
  METHODS
  From March 2010 to December 2013, 20 consecutive patients with BCS, due to long-segment obstruction of three hepatic veins, treated with accessory hepatic vein recanalization (11 males, 9 females; mean age, 33.4±10.9 years; range, 22-56 years) were included in this retrospective study. Data on technical success, clinical success, and follow-up were collected and analyzed.
  
  
  RESULTS
  Technical and clinical success was achieved in all patients. Each patient was managed with a single accessory hepatic vein recanalization procedure. No procedure-related complications occurred. The diameter of the accessory hepatic vein was 8.45±1.47 mm (6-11 mm) at the stem, and there were many collateral circulations between the hepatic vein and the accessory hepatic vein. The mean pressure of accessory hepatic vein decreased from 47.50±5.59 cm H2O before treatment to 28.80±3.47 cm H2O after treatment (P < 0.001). Abnormal levels of total bilirubin, albumin, aspartate aminotransferase, and alanine transaminase improved after the treatment. During the follow-up, three patients experienced restenosis or stenting of the accessory hepatic vein.
  
  
  CONCLUSIONS
  In BCS due to long-segment obstruction of the hepatic veins, it is important to confirm whether there is a compensatory accessory hepatic vein. For patients with a compensatory but obstructed accessory hepatic vein, recanalization is a simple, safe, and effective treatment option.
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Xuzhou Medical College, Jiangsu, China. weiningjieru@163.com.
authors.forename: Yu Fei
authors.initials: YF
authors.lastname: Fu
authors.forename: Hao
authors.initials: H
authors.lastname: Xu
authors.forename: Ke
authors.initials: K
authors.lastname: Zhang
authors.forename: Qing Qiao
authors.initials: QQ
authors.lastname: Zhang
authors.forename: Ning
authors.initials: N
authors.lastname: Wei
mesh_terms: D000328:Adult; D000800:Angioplasty, Balloon / Q000379:methods*; D006502:Budd-Chiari Syndrome / Q000473:pathology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006503:Hepatic Veins / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult