Sparano J, Chang J, Trasi S, Bonanno C
Am J Med. 1987 Apr;82(4):821-8. doi: 10.1016/0002-9343(87)90022-2.
A patient with the Budd-Chiari syndrome due to membranous obstruction of the right hepatic vein and long segmental obstruction of the inferior vena cava who was successfully treated with percutaneous transluminal angioplasty is described. Review of the literature revealed 14 prior cases of balloon dilatation of the hepatic venous system: 10 of the hepatic portion of the inferior vena cava, three of the right hepatic vein, and one of the left hepatic vein. Follow-up ranged from six months to 37 months. No serious complications were reported. All attempts at dilatation were successful, but reocclusion occurred in six patients, three of whom had occlusion of the hepatic vein. All but one patient with reocclusion, however, underwent repeated angioplasty, which was successful in all cases attempted. Two patients who had repeated angioplasty required no further therapy, but two patients required a total of three angioplasties and two patients required four angioplasties. Successful angioplasty was accompanied by resolution of clinical symptoms in all patients described. It is concluded that percutaneous transluminal angioplasty is a safe and effective mode of therapy in the management of the Budd-Chiari syndrome due to membranous obstruction of the hepatic portion of the inferior vena cava or the hepatic veins.
本文描述了一名因右肝静脉膜性梗阻和下腔静脉长节段梗阻导致布加综合征的患者，其经皮腔内血管成形术治疗成功。文献回顾显示，此前有14例肝静脉系统球囊扩张术的病例：下腔静脉肝段10例，右肝静脉3例，左肝静脉1例。随访时间为6个月至37个月。未报告严重并发症。所有扩张尝试均成功，但6例患者发生再闭塞，其中3例为肝静脉闭塞。然而，除1例再闭塞患者外，其他患者均接受了重复血管成形术，所有尝试的病例均成功。2例接受重复血管成形术的患者无需进一步治疗，但2例患者共需要3次血管成形术，2例患者需要4次血管成形术。所述所有患者成功的血管成形术均伴有临床症状的缓解。结论是，经皮腔内血管成形术是治疗因下腔静脉肝段或肝静脉膜性梗阻导致的布加综合征的一种安全有效的治疗方式。
