Joueidi Faisal, Alhanaee Amnah, Alsuhaibani Hamad, Albenmousa Ali, Joueidi Ahmad, Elhassan Ahmed, Nasir Abdallah Nabeel, Marquez Kris Ann Hervera, Alghamdi Saad, Al Hamoudi Waleed, Abualganam Saad, Broering Dieter, Bzeizi Khalid Ibrahim
College of Medicine, Alfaisal University, Riyadh 11451, Saudi Arabia.
Department of Liver & Small Bowel Health Centre, Organ Transplant Centre of Excellence, King Faisal Specialist Hospital & Research Centre, Riyadh 11451, Saudi Arabia.
J Clin Med. 2024 Oct 1;13(19):5858. doi: 10.3390/jcm13195858.
: Despite several challenges in clinical management, there has been significant progress in understanding the aetiology, natural history and outcomes of Budd-Chiari syndrome (BCS) treatments. This study aims to evaluate the outcomes of transjugular intrahepatic portosystemic shunt (TIPS) using covered stent in management of BCS. : We conducted a retrospective analysis of 70 BCS patients who underwent TIPS using covered stents between January 2010 and December 2022 at a single tertiary liver transplant centre. Patients' clinical features, laboratory parameters, and imagine findings were collected before and after TIPS. The primary endpoint was overall survival. : TIPS was performed on 70 patients with BCS out of a total of 88 patients. The remaining patients (18) underwent liver transplantation. The mean age was 37.7 ± 11.2 years at time of diagnosis and the majority were female (64.35). The most common symptoms and signs at presentation were abdominal pain, jaundice, ascites, and variceal bleeding. Over a median followup of 76 months, the survival rates at 1, 3, and 5 years were 98.8%, 97.9%, and 97.7%, respectively. Patients who underwent TIPS alone had better survival that patients with BCS who required liver transplantation (LTx) ( = 0.003). : In our study TIPS provided a highly effective treatment option for BCS patients. The long-term favourability of the outcome was not impacted by the need for repeated TIPS revision. Use of covered stents was instrumental in reducing shunt dysfunction rates. Prospective and larger studies are needed to further optimize therapeutic strategies in this challenging population.
尽管在临床管理方面存在诸多挑战，但在理解布加综合征（BCS）的病因、自然病程及治疗结果方面已取得显著进展。本研究旨在评估使用覆膜支架的经颈静脉肝内门体分流术（TIPS）治疗BCS的效果。我们对2010年1月至2022年12月期间在一家三级肝移植中心接受覆膜支架TIPS治疗的70例BCS患者进行了回顾性分析。收集患者TIPS前后的临床特征、实验室参数及影像学检查结果。主要终点为总生存期。在总共88例患者中，70例BCS患者接受了TIPS治疗。其余18例患者接受了肝移植。诊断时的平均年龄为37.7±11.2岁，大多数为女性（64.35%）。最常见的症状和体征为腹痛、黄疸、腹水及静脉曲张出血。中位随访76个月，1年、3年和5年生存率分别为98.8%、97.9%和97.7%。单纯接受TIPS治疗的患者比需要肝移植（LTx）的BCS患者生存率更高（P = 0.003）。在我们的研究中，TIPS为BCS患者提供了一种高效的治疗选择。长期良好的治疗结果不受重复TIPS翻修需求的影响。使用覆膜支架有助于降低分流功能障碍发生率。需要进行前瞻性、更大规模的研究，以进一步优化针对这一具有挑战性人群的治疗策略。
