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2015 ; 21
(2
): 148-53
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Accessory hepatic vein recanalization for treatment of Budd-Chiari syndrome due
to long-segment obstruction of the hepatic vein: initial clinical experience
#MMPMID25616271
Fu YF
; Xu H
; Zhang K
; Zhang QQ
; Wei N
Diagn Interv Radiol
2015[Mar]; 21
(2
): 148-53
PMID25616271
show ga
PURPOSE: 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.