title: Retrograde puncture assisted hepatic vein recanalization in treating Budd-Chiari syndrome with segmental obstruction of hepatic vein.
abstract: OBJECTIVE
  This study aimed at investigating the feasibility and effectiveness of retrograde puncture assisted hepatic vein (HV) recanalization in management of Budd-Chiari syndrome (BCS) patients with segmental obstruction of HV.
  
  
  METHODS
  From May 2011 to August 2014, 76 BCS patients with obstruction of HV were treated by routine transjugular HV recanalization in our center. Among them, 17 patients with segmental obstruction (obstruction length >1 cm) of HV experienced failure of the routine transjugular HV recanalization and underwent retrograde puncture assisted HV recanalization. Data on technical success, clinical success and follow-up were collected and analyzed retrospectively.
  
  
  RESULTS
  Retrograde puncture assisted HV recanalization was technically successful in 14 of 17 (82 %) patients. Of these 14 patients, 12 patients underwent HV balloon dilation, and 2 patients underwent HV stent insertion. No procedure-related complications occurred in any of our patient. Clinical success was achieved in all of the 14 patients who experienced technical success. The mean HV pressure decreased from 43.6 ± 6.7 cmH2O before treatment to 18.4 ± 4.8 cmH2O after treatment (P < 0.001). BCS-related symptoms began to improve on the next day following the treatment. During 4-43 months (mean 17.4 ± 10.8 months) of follow-up, three patients experienced re-obstruction of HV.
  
  
  CONCLUSIONS
  Retrograde puncture assisted HV recanalization is a simple, safe, and effective treatment for BCS patients with segmental obstruction of HV. It can serve as an additional treatment option for patients who experience the technical failure of routine transjugular HV recanalization.
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Xuzhou Medical College, 99 West Huai-hai Road, 221006, Xuzhou, China.
authors.forename: Yan-Feng
authors.initials: YF
authors.lastname: Cui
authors.affiliation: Department of Radiology, Xuzhou Central Hospital, 199 South Jie-fang Road, 221009, Xuzhou, China.
authors.forename: Yu-Fei
authors.initials: YF
authors.lastname: Fu
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Xuzhou Medical College, 99 West Huai-hai Road, 221006, Xuzhou, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Wei
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Xuzhou Medical College, 99 West Huai-hai Road, 221006, Xuzhou, China.
authors.forename: Hong-Chao
authors.initials: HC
authors.lastname: Zhu
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Xuzhou Medical College, 99 West Huai-hai Road, 221006, Xuzhou, China. xuhao587@163.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D006502:Budd-Chiari Syndrome / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006503:Hepatic Veins / Q000601:surgery*; D006504:Hepatic Veno-Occlusive Disease / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000379:methods*; D016896:Treatment Outcome
keywords: Budd–Chiari syndrome; Hepatic vein; Retrograde puncture