Department of Interventional Radiology, The Affiliated Hospital of Xuzhou Medical University.
Department of Clinical Medicine, Xuzhou Medical University, Xuzhou, China.
Eur J Gastroenterol Hepatol. 2021 May 1;33(5):709-716. doi: 10.1097/MEG.0000000000001784.
Interventional treatment is the main therapy for Budd-Chiari syndrome (BCS) with hepatic vein obstruction. The aim of this study was to investigate the long-term outcomes of endovascular management for BCS with chronic accessory hepatic vein (AHV) obstruction.
In total, 68 patients with primary BCS who underwent AHV dilation with or without stenting from January 2008 to December 2018 were included in this retrospective study. The technical success rate and complications were recorded. Cumulative patency rates were estimated by the Kaplan-Meier curves and compared using the log-rank test.
Technical success was achieved in all 68 patients, and AHV patency was confirmed by postoperative angiography. Fifty-two patients underwent balloon dilation alone and 16 underwent adjunctive stent implantation. During a mean follow-up period of 60.2 ± 30.5 months, AHV reocclusion occurred in 14 patients in the balloon group and four patients in the stent group (χ2 = 0.034, P = 0.855). The overall cumulative 1-, 3-, 5-, and 7-year primary and secondary AHV patency rates were 90.6, 76.6, 72.0, and 68.2% and 98.4, 91.4, 89.2, and 89.2%, respectively. The cumulative 1-, 3-, 5-, and 7-year primary patency rates of the AHV were 89.8, 73.8, 71.2, and 71.2% in the balloon group and 93.3, 86.2, 75.4, and 60.3% in the stent group, respectively. There was no statistically significant difference between the two groups (P = 0.934).
Interventional treatment of BCS with chronic AHV obstruction has good long-term outcomes. Both balloon dilation alone and adjunctive stent implantation can be used for AHV recanalization.
介入治疗是肝静脉阻塞型布加综合征（BCS）的主要治疗方法。本研究旨在探讨慢性副肝静脉（AHV）阻塞型 BCS 的血管内治疗的长期疗效。
回顾性分析 2008 年 1 月至 2018 年 12 月期间收治的 68 例行 AHV 扩张术（单纯球囊扩张或联合支架植入）的原发性 BCS 患者的临床资料。记录技术成功率及并发症。采用 Kaplan-Meier 曲线估计累积通畅率，并采用对数秩检验比较。
68 例患者均成功完成手术，术后血管造影证实 AHV 通畅。52 例患者单纯行球囊扩张，16 例患者行支架植入。中位随访时间为 60.2±30.5 个月，单纯球囊扩张组 14 例和支架植入组 4 例患者出现 AHV 再闭塞（χ2=0.034，P=0.855）。总体而言，1、3、5、7 年的 AHV 通畅率分别为 90.6%、76.6%、72.0%和 68.2%和 98.4%、91.4%、89.2%和 89.2%。单纯球囊扩张组的 AHV 1、3、5、7 年通畅率分别为 89.8%、73.8%、71.2%和 71.2%，支架植入组分别为 93.3%、86.2%、75.4%和 60.3%。两组间差异无统计学意义（P=0.934）。
介入治疗慢性 AHV 阻塞型 BCS 具有良好的长期疗效。单纯球囊扩张和联合支架植入均可用于 AHV 再通。
