Department of Radiology, Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Radiology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China.
Abdom Radiol (NY). 2021 Jul;46(7):3456-3463. doi: 10.1007/s00261-021-02977-1. Epub 2021 Feb 25.
To evaluate the clinical efficacy and long-term outcomes associated with the treatment of hepatic vein (HV)-type Budd-Chiari syndrome (BCS) via accessory HV (AHV) recanalization.
In total, 26 HV-type BCS patients underwent AHV recanalization between July 2014 and December 2019 at our hospital, while 73 HV-type BCS patients without compensatory AHV underwent main HV (MHV) recanalization and served as controls in the present study. Short- and long-term clinical outcomes were compared.
AHV and MHV recanalization approaches were both associated with 100% technical success rates, with one recanalization procedure being performed per patient. Respective clinical success rates for the AHV and MHV recanalization approaches were 96.2% and 94.5% (P = 0.744). Re-obstruction rates were comparable between these two approaches at 20% and 34.8%, respectively (P = 0.17). Primary cumulative 1-, 2-, and 5-year patency rates in the AHV group were 96.0%, 91.6%, and 76.3%, respectively, whereas in the MHV group, these three respective rates were 87.0%, 78.6%, and 58.6% (P = 0.048). Secondary cumulative 1-, 2-, and 5-year patency rates in the AHV group were 96.0%, 96.0%, and 96.0%, respectively, whereas in the MHV group, they were 97.1%, 97.1%, and 81.8%, respectively (P = 0.289). Cumulative 1-, 2-, and 5-year survival rates for AHV group patients were 96.0%, 96.0%, and 96.0%, respectively, while for the MHV group, these respective rates were 98.6%, 95.2%, and 89.7% (P = 0.462).
HV-type BCS can be safely and effectively treated via AHV recanalization, which may achieve longer patency relative to MHV recanalization.
评估通过副肝静脉（AHV）再通治疗肝静脉（HV）-Budd-Chiari 综合征（BCS）的临床疗效和长期结局。
2014 年 7 月至 2019 年 12 月，我院对 26 例 HV 型 BCS 患者行 AHV 再通治疗，同期对 73 例无代偿性 AHV 的 HV 型 BCS 患者行主肝静脉（MHV）再通治疗作为对照。比较两组患者的短期和长期临床结局。
AHV 和 MHV 再通技术成功率均为 100%，每位患者均行 1 次再通术。AHV 和 MHV 再通组的临床成功率分别为 96.2%和 94.5%（P=0.744）。再狭窄率分别为 20%和 34.8%（P=0.17）。AHV 组的 1、2、5 年原发性累积通畅率分别为 96.0%、91.6%和 76.3%，而 MHV 组的相应比例分别为 87.0%、78.6%和 58.6%（P=0.048）。AHV 组的 1、2、5 年继发性累积通畅率分别为 96.0%、96.0%和 96.0%，而 MHV 组的相应比例分别为 97.1%、97.1%和 81.8%（P=0.289）。AHV 组患者的 1、2、5 年累积生存率分别为 96.0%、96.0%和 96.0%，而 MHV 组的相应比例分别为 98.6%、95.2%和 89.7%（P=0.462）。
HV 型 BCS 可通过 AHV 再通安全有效地治疗，其通畅率可能优于 MHV 再通。
