Department of Gastroenterology, First Affiliated Hospital of Medical College, Xi'an Jiao Tong University, Xi'an, China.
Dig Dis Sci. 2010 Sep;55(9):2659-63. doi: 10.1007/s10620-009-1087-7. Epub 2009 Dec 25.
To evaluate the efficacy of intravascular intervention in the management of different types of Budd-Chiari syndrome.
Fifty-three patients of BCS were clinically diagnosed and interventionally treated in terms of their signs and symptoms of portal hypertension and occlusive inferior vena cava/or hepatic veins with the combination of Doppler ultrasonography, CT scan, and angiography. The interventional methods applied in this study included percutaneous transluminal angioplasty and IVC stent implantation (PTA+IVC stent); transjugular hepatic veno-stent placement (PTA+HV stent) or transjugular transluminal hepatic veno-inferior vena cava stent placement and transcaval transjugular intrahepatic portocaval shunt.
The success rate of intravascular interventional therapy was 92.45% (49/53). After interventional therapy, the patients' pleural effusion, ascites, prominent veins formation of bilateral flanks or backs alleviated, hepatomegaly reduced, and the urinary output increased. The longest follow-up case was 13 years with patent stent. Two patients died of pulmonary embolization or pericardial tamponade during surgery.
Intravascular intervention is a safe and effective therapy for most types of BCS.
评价血管内介入治疗不同类型布加综合征的疗效。
对 53 例布加综合征患者根据其门脉高压和下腔静脉/肝静脉阻塞的体征和症状，结合多普勒超声、CT 扫描和血管造影进行临床诊断和介入治疗。本研究采用的介入方法包括经皮腔内血管成形术和静脉支架植入术（PTA+IVC 支架）；经颈静脉肝静脉支架置入术（PTA+HV 支架）或经颈静脉经肝静脉-下腔静脉支架置入术和经腔静脉经颈静脉肝内门腔分流术。
血管内介入治疗成功率为 92.45%（49/53）。介入治疗后，患者胸腔积液、腹水、双侧腰部或背部静脉曲张减轻，肝肿大减轻，尿量增加。最长随访病例为 13 年，支架通畅。2 例患者在手术中死于肺栓塞或心包填塞。
血管内介入治疗是大多数类型布加综合征的一种安全有效的治疗方法。
