Department of Radiodiagnosis and Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo 11341, Egypt.
World J Gastroenterol. 2011 Feb 21;17(7):906-13. doi: 10.3748/wjg.v17.i7.906.
To evaluate outcome of patients with Budd-Chiari syndrome after balloon angioplasty ± stenting or transjugular intrahepatic portosystemic shunt (TIPS).
Twenty five patients with Budd-Chiari syndrome admitted to Ain Shams University Hospitals, Tropical Medicine Department were included. Twelve patients (48%) with short segment occlusion were candidates for angioplasty; with stenting in ten cases and without stenting in two. Thirteen patients (52%) had Transjugular Intrahepatic Portosystemic Shunt. Patients were followed up for 12-32 mo.
Patency rate in patients who underwent angioplasty ± stenting was 83.3% at one year and at end of follow up. The need of revision was 41.6% with one year survival of 100%, dropped to 91.6% at end of follow up. In patients who had Transjugular Intrahepatic Portosystemic Shunt, patency rate was 92.3% at one year, dropped to 84.6% at end of follow up. The need of revision was 38.4% with one year and end of follow up survival of 100%. Patients with patent shunts showed marked improvement compared to those with occluded shunts.
Morbidity and mortality following angioplasty ± stenting and TIPS are low with satisfactory outcome. Proper patient selection and management of shunt dysfunction are crucial in improvement.
评估布加综合征患者在球囊血管成形术±支架置入或经颈静脉肝内门体分流术（TIPS）后的治疗效果。
本研究纳入了 25 例在艾因夏姆斯大学医院热带医学系就诊的布加综合征患者。12 例（48%）短节段闭塞患者为血管成形术候选者，其中 10 例接受支架置入，2 例未接受支架置入。13 例（52%）患者行 TIPS。患者接受了 12-32 个月的随访。
接受血管成形术±支架置入的患者，其血管通畅率在 1 年和随访结束时分别为 83.3%和 83.3%。需要再次介入的比例为 41.6%，1 年生存率为 100%，随访结束时生存率降至 91.6%。行 TIPS 的患者，1 年时血管通畅率为 92.3%，随访结束时降至 84.6%。需要再次介入的比例为 38.4%，1 年和随访结束时的生存率均为 100%。与闭塞患者相比，通畅患者的症状有明显改善。
血管成形术±支架置入和 TIPS 的并发症和死亡率低，治疗效果良好。适当的患者选择和分流功能障碍的管理对改善预后至关重要。
