title: Endovascular Management of Budd-Chiari Syndrome with Inferior Vena Cava Thrombosis: A 14-Year Single-Center Retrospective Report of 55 Patients.
abstract: OBJECTIVE
  To evaluate safety and efficacy of balloon dilation and stent placement combined with thrombus aspiration and thrombolysis to treat patients with Budd-Chiari syndrome (BCS) with inferior vena cava (IVC) thrombosis.
  
  
  METHODS
  Charts from 55 consecutive patients with primary BCS and IVC thrombosis treated between April 2000 and August 2014 were retrospectively analyzed. Transcatheter aspiration and percutaneous recanalization were attempted in all patients, and stents were placed if balloon dilation was successful. Catheter-directed thrombolysis was performed when evident clot burden was present after recanalization.
  
  
  RESULTS
  Technically successful IVC recanalization was achieved in 53 of 55 patients (96.4%). Technical failures in 2 patients were due to long segment of IVC obstruction. A stent was placed in 47 of 53 patients (88.7%). Thrombus was successfully aspirated in 23 patients, and thrombolytic treatment was administered to 13 patients. Median follow-up was 58 months (range, 8-180 mo). No symptomatic pulmonary embolism occurred. Reocclusion occurred in 8 patients, and 6 of these patients (75%) underwent repeat recanalization by balloon dilation with or without stents. Cumulative 1-, 5-, and 10-year primary patency rates were 94%, 89%, and 66%. Alanine transaminase and alkaline phosphatase levels were independent risk factors for reocclusion. Cumulative 1-, 5-, and 10-year survival rates were 90%, 86%, and 86%. Child-Pugh score and reocclusion were independent predictors of survival.
  
  
  CONCLUSIONS
  Percutaneous vena caval balloon dilation and stent placement with thrombus aspiration and thrombolytic therapy is safe and effective for treatment of patients with BCS and IVC thrombosis.
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, No.169 Changle West Road, Xi'an, Shanxi, China.
authors.forename: Xiangchen
authors.initials: X
authors.lastname: Meng
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, No.169 Changle West Road, Xi'an, Shanxi, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Lv
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, No.169 Changle West Road, Xi'an, Shanxi, China.
authors.forename: Bojing
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, No.169 Changle West Road, Xi'an, Shanxi, China.
authors.forename: Chuangye
authors.initials: C
authors.lastname: He
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, No.169 Changle West Road, Xi'an, Shanxi, China.
authors.forename: Wengang
authors.initials: W
authors.lastname: Guo
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, No.169 Changle West Road, Xi'an, Shanxi, China.
authors.forename: Bohan
authors.initials: B
authors.lastname: Luo
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, No.169 Changle West Road, Xi'an, Shanxi, China.
authors.forename: Zhanxin
authors.initials: Z
authors.lastname: Yin
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, No.169 Changle West Road, Xi'an, Shanxi, China.
authors.forename: Daiming
authors.initials: D
authors.lastname: Fan
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, No.169 Changle West Road, Xi'an, Shanxi, China. Electronic address: hangh@fmmu.edu.cn.
authors.forename: Guohong
authors.initials: G
authors.lastname: Han
mesh_terms: D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D002681:China; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D016016:Proportional Hazards Models; D015641:Radiography, Interventional; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013396:Suction; D017131:Thrombectomy / Q000009:adverse effects / Q000401:mortality; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000503:physiopathology