Interventional Therapy for Budd-Chiari Syndrome Secondary to Hepatic Venous Obstruction with 8-Year Follow-Up_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 DINGPeng-xu ¹ ,  ZHANGShui-jun ² , LIZhen ¹ , FUMing-ti ¹ , HUAZhao-hui ¹ , ZHANGWen-guang ¹ , WANGZhong-gao ^1,3,4

1. Department of Endovascular Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, Henan Province, China;
2. Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, Henan Province, China;
3. Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
4. Department of Vascular Surgery, The Second Artillery General Hospital of Chinese People's Liberation Army, Beijing 100088, China;

Corresponding?author：

ZHANGShui-jun, Email: zhangshuijun@zzu.edu.cn

Keywords：

Budd-Chiari syndrome; Hepatic vein; Percutaneous transluminal angioplasty; Effect

DOI：

10.7507/1007-9424.20140356

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the applicability and the long-term outcomes of percutaneous transluminal balloon angioplasty (PTBA) in the management of Budd-Chiari syndrome (BCS) secondary to hepatic venous obstruction. Methods Clinical data of 94 patients with BCS secondary to hepatic venous obstruction who underwent PTBA of the hepatic vein from Jan. 2005 to Dec. 2013 in The First Affiliated Hospital of Zhengzhou University were analyzed retrospectively. Results PTBA were technically successful in 93 of the 94 patients (98.94%). Ninety-one of the 93 patients (97.85%) were treated with PTBA alone and 2 patients (2.15%) were treated with PTBA and stent. One patient with primary hepatocellular carcinoma (HCC) underwent resection of liver cancer after interventional therapy. Hepatic venous pressure value of 93 patients was significantly decreased after balloon interventional procedures. Symptoms were significantly improved in the 93 patients who had successful PTBA. Procedure-related complications occurred in 6 of the 93 patients (6.38%), and 1 patient (1.06%) died in 2 months after operation because of intra-abdominal bleeding. Two patients lost during follow-up with a follow-up loss rate of 2.15% (2/93), and the 91 patients were followed-up for 1-96 months [(49.72±28.60) months]. HCC occurred in 3 patients during follow-up period. Restenosis of targeted hepatic vein developed in 8 patients (11 times), and the overall recurrence rate was 11.83% (11/93). One patient of them underwent surgical operation, the remaining 7 patients underwent PTBA successfully. The 1-, 2-, 3-, and 5-year primary patency rates were 97.47% (77/79), 94.20% (65/69), 91.67% (55/60), and 91.67% (33/36), respectively. The 1-, 2-, 3-, and 5-year secondary patency rates were 98.73% (78/79), 98.55% (68/69), 98.33% (59/60), and 97.22% (35/36), respectively. Conclusions PTBA is a safe and effective treatment for BCS with the hepatic vein obstruction and had good mild-term outcomes. The liver function of the patients improved after treatment, with few patients died from HCC caused by hepatic cirrhosis, so we must pay attention on it, as well as the targeted hepatic vein.

Citation： DINGPeng-xu, ZHANGShui-jun, LIZhen, FUMing-ti, HUAZhao-hui, ZHANGWen-guang, WANGZhong-gao. Interventional Therapy for Budd-Chiari Syndrome Secondary to Hepatic Venous Obstruction with 8-Year Follow-Up. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(12): 1500-1506. doi: 10.7507/1007-9424.20140356 Copy

1.	李彥豪, 陳勇.介入治療技術在Budd-Chiari綜合征治療中的地位[J].實用醫學雜志, 2000, 16(5):350-351.
2.	祖茂衡.Budd-Chiari綜合征的影像綜合診斷與介入治療[J].中國醫學計算機成像雜志, 2002, 8(2):108-115.
3.	韓新巍, 丁鵬緒, 吳剛.布加綜合征下腔靜脈阻塞直徑30 mm大球囊擴張的可行性研究[J].介入放射學雜志, 2008, 17(4):243-246.
4.	張希全, 劉海軍, 鹿詠紅, 等.經皮經肝穿刺門靜脈行胃底食管曲張靜脈栓塞術治療上消化道出血[J].中華普通外科雜志, 2005, 20(4):218-220.
5.	肖紹樹, 周學斌.部分脾栓塞治療肝硬化門脈高壓癥和脾功能亢進的研究進展[J].實用肝臟病雜志, 2006, 9(3):183-184.
6.	韓新巍, 李永東.布-加綜合征介入治療技術操作規范的幾點建議[J].介入放射學雜志, 2002, 11(4):316-318.
7.	Klein AS.Management of Budd-Chiari syndrome[J].Liver Transpl, 2006, 12(11 Suppl 2):S23-S28.
8.	Qiao T, Liu CJ, Liu C, et al.Interventional endovascular treatment for Budd-Chiari syndrome with long-term follow-up[J].Swiss Med Wkly, 2005, 135(21-22):318-326.
9.	成德雷, 徐浩, 華榮, 等.原發性布加綜合征的病因及臨床特征研究[J].中華肝臟病雜志, 2013, 21(11):850-854.
10.	張曦彤, 徐克, 祖茂衡, 等.Budd-Chiari綜合征肝靜脈閉塞的介入治療[J].中華放射學雜志, 2003, 37(5):449-453.
11.	Patil P, Deshmukh H, Popat B, et al.Spectrum of imaging in Budd Chiari syndrome[J].J Med Imaging Radiat Oncol, 2012, 56(1):75-83.
12.	韓新巍, 丁鵬緒, 劉冰妍, 等.Budd-Chiari綜合征:國人病變肝靜脈分布的影像學研究[J].臨床放射學雜志, 2009, 28(2):201-204.
13.	韓新巍, 徐克, 祖茂衡, 等.布-加綜合征介入治療與研究進展[M].鄭州:鄭州大學出版社, 2010:200-210.
14.	祖茂衡.布-加綜合征的影像診斷與介入治療[M].北京:科學出版社, 2004:256-265.
15.	祖茂衡, 徐浩, 顧玉明, 等.布-加綜合征介入治療——導絲貫穿法行下腔靜脈和肝靜脈成形術[J].介入放射學雜志, 2006, 15(9):521-523.
16.	Li TX, Zhai ST, Pang ZG, et al.Feasibility and midterm outcomes of percutaneous transhepatic balloon angioplasty for symptomatic Budd-Chiari syndrome secondary to hepatic venous obstruction[J].J Vasc Surg, 2009, 50(5):1079-1084.
17.	李金保, 權暉, 薛克, 等.經皮胃冠狀靜脈栓塞術后預防肝穿刺道出血的方法探討[J].介入放射學雜志, 2014, 23(1):73-75.
18.	李征然, 單鴻, 朱康順, 等.肝靜脈型Budd-Chiari綜合征的介入治療[J].介入放射學雜志, 2004, 13(1):25-27.
19.	祖茂衡.布-加綜合征的影像診斷與介入治療[M].北京:科學出版社, 2004:324-327.
20.	孫振陽, 芮清峰, 劉允樂.38例肝靜脈膜型布加綜合征診治分析[J].安徽醫藥, 2013, 17(5):795-796.
21.	Rautou PE, Douarin L, Denninger MH, et al.Bleeding in patients with Budd-Chiari syndrome[J].J Hepatol, 2011, 54(1):56-63.
22.	Kawaguchi T, Sata M, Ono N, et al.Budd-Chiari syndrome complicated by hepatocellular carcinoma with no evidence of infection with hepatitis virus:a case report[J].Hepatogastroenterology, 1999, 46(30):3237-3240.
23.	Vilgrain V, Lewin M, Vons C, et al.Hepatic nodules in Budd-Chiari syndrome:imaging features[J].Radiology, 1999, 210(2):443-450.
24.	Liu FY, Wang MQ, Duan F, et al.Hepatocellular carcinoma associated with Budd-Chiari syndrome:imaging features and transcatheter arterial chemoembolization[J].BMC Gastroenterol, 2013, 13:105.
25.	Aoki K, Miyamoto T, Murata H, et al.Significance of accessory hepatic venography to evaluate the intrahepatic venous system for obstruction of the inferior vena cava at the hepatic portion with main hepatic vein obstruction[J].Nihon Geka Gakkai Zasshi, 1986, 87(6):704.
26.	Simson IW.Membranous obstruction of the inferior vena cava and hepatocellular carcinoma in South Africa[J].Gastroenterology, 1982, 82(2):171-178.
27.	Dilawari JB, Bambery P, Chawla Y, et al.Hepatic outflow obst-ruction (Budd-Chiari syndrome).Experience with 177 patients and a review of the literature[J].Medicine (Baltimore), 1994, 73(1):21-36.
28.	Valla DC.Primary Budd-Chiari syndrome[J].J Hepatol, 2009, 50(1):195-203.
29.	Chen MF, Hwang TL, Jeng LB, et al.Postoperative recurrence of hepatocellular carcinoma.Two hundred five consecutive pati-ents who underwent hepatic resection in 15 years[J].Arch Surg, 1994, 129(7):738-742.

1. 李彥豪, 陳勇.介入治療技術在Budd-Chiari綜合征治療中的地位[J].實用醫學雜志, 2000, 16(5):350-351.
2. 祖茂衡.Budd-Chiari綜合征的影像綜合診斷與介入治療[J].中國醫學計算機成像雜志, 2002, 8(2):108-115.
3. 韓新巍, 丁鵬緒, 吳剛.布加綜合征下腔靜脈阻塞直徑30 mm大球囊擴張的可行性研究[J].介入放射學雜志, 2008, 17(4):243-246.
4. 張希全, 劉海軍, 鹿詠紅, 等.經皮經肝穿刺門靜脈行胃底食管曲張靜脈栓塞術治療上消化道出血[J].中華普通外科雜志, 2005, 20(4):218-220.
5. 肖紹樹, 周學斌.部分脾栓塞治療肝硬化門脈高壓癥和脾功能亢進的研究進展[J].實用肝臟病雜志, 2006, 9(3):183-184.
6. 韓新巍, 李永東.布-加綜合征介入治療技術操作規范的幾點建議[J].介入放射學雜志, 2002, 11(4):316-318.
7. Klein AS.Management of Budd-Chiari syndrome[J].Liver Transpl, 2006, 12(11 Suppl 2):S23-S28.
8. Qiao T, Liu CJ, Liu C, et al.Interventional endovascular treatment for Budd-Chiari syndrome with long-term follow-up[J].Swiss Med Wkly, 2005, 135(21-22):318-326.
9. 成德雷, 徐浩, 華榮, 等.原發性布加綜合征的病因及臨床特征研究[J].中華肝臟病雜志, 2013, 21(11):850-854.
10. 張曦彤, 徐克, 祖茂衡, 等.Budd-Chiari綜合征肝靜脈閉塞的介入治療[J].中華放射學雜志, 2003, 37(5):449-453.
11. Patil P, Deshmukh H, Popat B, et al.Spectrum of imaging in Budd Chiari syndrome[J].J Med Imaging Radiat Oncol, 2012, 56(1):75-83.
12. 韓新巍, 丁鵬緒, 劉冰妍, 等.Budd-Chiari綜合征:國人病變肝靜脈分布的影像學研究[J].臨床放射學雜志, 2009, 28(2):201-204.
13. 韓新巍, 徐克, 祖茂衡, 等.布-加綜合征介入治療與研究進展[M].鄭州:鄭州大學出版社, 2010:200-210.
14. 祖茂衡.布-加綜合征的影像診斷與介入治療[M].北京:科學出版社, 2004:256-265.
15. 祖茂衡, 徐浩, 顧玉明, 等.布-加綜合征介入治療——導絲貫穿法行下腔靜脈和肝靜脈成形術[J].介入放射學雜志, 2006, 15(9):521-523.
16. Li TX, Zhai ST, Pang ZG, et al.Feasibility and midterm outcomes of percutaneous transhepatic balloon angioplasty for symptomatic Budd-Chiari syndrome secondary to hepatic venous obstruction[J].J Vasc Surg, 2009, 50(5):1079-1084.
17. 李金保, 權暉, 薛克, 等.經皮胃冠狀靜脈栓塞術后預防肝穿刺道出血的方法探討[J].介入放射學雜志, 2014, 23(1):73-75.
18. 李征然, 單鴻, 朱康順, 等.肝靜脈型Budd-Chiari綜合征的介入治療[J].介入放射學雜志, 2004, 13(1):25-27.
19. 祖茂衡.布-加綜合征的影像診斷與介入治療[M].北京:科學出版社, 2004:324-327.
20. 孫振陽, 芮清峰, 劉允樂.38例肝靜脈膜型布加綜合征診治分析[J].安徽醫藥, 2013, 17(5):795-796.
21. Rautou PE, Douarin L, Denninger MH, et al.Bleeding in patients with Budd-Chiari syndrome[J].J Hepatol, 2011, 54(1):56-63.
22. Kawaguchi T, Sata M, Ono N, et al.Budd-Chiari syndrome complicated by hepatocellular carcinoma with no evidence of infection with hepatitis virus:a case report[J].Hepatogastroenterology, 1999, 46(30):3237-3240.
23. Vilgrain V, Lewin M, Vons C, et al.Hepatic nodules in Budd-Chiari syndrome:imaging features[J].Radiology, 1999, 210(2):443-450.
24. Liu FY, Wang MQ, Duan F, et al.Hepatocellular carcinoma associated with Budd-Chiari syndrome:imaging features and transcatheter arterial chemoembolization[J].BMC Gastroenterol, 2013, 13:105.
25. Aoki K, Miyamoto T, Murata H, et al.Significance of accessory hepatic venography to evaluate the intrahepatic venous system for obstruction of the inferior vena cava at the hepatic portion with main hepatic vein obstruction[J].Nihon Geka Gakkai Zasshi, 1986, 87(6):704.
26. Simson IW.Membranous obstruction of the inferior vena cava and hepatocellular carcinoma in South Africa[J].Gastroenterology, 1982, 82(2):171-178.
27. Dilawari JB, Bambery P, Chawla Y, et al.Hepatic outflow obst-ruction (Budd-Chiari syndrome).Experience with 177 patients and a review of the literature[J].Medicine (Baltimore), 1994, 73(1):21-36.
28. Valla DC.Primary Budd-Chiari syndrome[J].J Hepatol, 2009, 50(1):195-203.
29. Chen MF, Hwang TL, Jeng LB, et al.Postoperative recurrence of hepatocellular carcinoma.Two hundred five consecutive pati-ents who underwent hepatic resection in 15 years[J].Arch Surg, 1994, 129(7):738-742.

Previous Article
Treatment and Follow-Up Results of Inferior Vena Cava Blocking Budd-Chiari Syndrome with Thrombosis
Next Article
Identification Between Budd-Chiari Syndrome and Hepatic Veno-Occlusive Disease

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Interventional Therapy for Budd-Chiari Syndrome Secondary to Hepatic Venous Obstruction with 8-Year Follow-Up

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content