Wang Z G, Wang S H, Wu J D
Vascular Institute, Post & Telecommunication Hospital, Beijing.
Zhonghua Yi Xue Za Zhi. 1995 Feb;75(2):97-9, 127.
We treated 33 cases of Budd-Chiari syndrome caused by localized occlusive lesions of the inferior vena cava (IVC) with balloon dilatation and stent deployment. Of the 33, 21 were male and 12 female. Complete "membranous" occlusion was found in 18, incomplete "membrane" in 6, and localized stenosis in 9. Seven cases recurred after transcardiac and membranotomy or cavoatial shunt or mesoatial shunt. Pure stent deployment was carried out in 24 cases, combined transcardiac and transfemoral approaches were used in 6, stent was placed during radical correction of IVC lesions in 3. Unrelieved intractable ascites were 5 cases because of hepatic venous occlusion or secondary cirrhosis, 3 of them were resolved by mesocaval anastomosis. The IVC pressures before and after stenting were 2.70 +/- 0.69kPa (1kPa = 0.98cmH2O) and 1.55 +/- 0.50kPa (P < 0.01) respectively. All but one (waiting for possible messocaval shunt) had excellent effect 6-23 months following the above mentioned therapy. We conclude that dilation and stenting plus necessary or additional surgery bring about a prosperous means for treating Budd-Chiari syndrome with localized lesions.