ORIGINAL ARTICLES   

Panminerva Medica 2013 December;55(4):371-6

Copyright © 2014 EDIZIONI MINERVA MEDICA

lingua: Inglese

Analysis of interventional treatments of Budd-Chiari Syndrome and the related complications: a study of 1006 cases

Wei X. ¹, Hao X. ¹, Da-Hai Y. ², Mao-Heng Z. ¹, Qing-Qiao Z. ¹, Yu-Ming G. ¹ ✉

¹ Department of Intervention, The Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu Province, China; ² Deparment of Radiation Oncology, Jiangsu Hospital of Traditional Chinese Medicine, The First Affiliated Hospital of Nanjing Traditional Chinese Medicine University, Nanjing, Jiangsu Province, China

Aim: The aim of this paper was to investigate the cause of intraoperative and postoperative complications in Budd-Chiari syndrome (BCS) and its prevention.
Methods: BCS Patients (1035) who were treated between 1990 and 2009 were included in the present study. Among these patients, there were 651 cases with inferior vena cava occlusion, 273 cases with hepatic vein obstruction and 111 cases with both the symptoms. Treatment for 28 patients failed due to various causes and 1 case diagnosed of obstruction in the right hepatic vein was not treated due to the compensation from the middle and left hepatic vein. The remaining 1006 cases were resolved by the percutaneous transluminal angioplasty (PTA), of which 746 cases had only PTA and 260 cases had both PTA and stent.
Results: There were complications in 66 (6.56%) cases after intervention and 2 patients (0.199%) died. Accidental surgical penetration of the pericardium or cardiac tamponade (0.99%) led to the death of 10 patients, among which 4 cases had cardiac tamponade and one died due to the tamponade. In 2 (0.199%) patients there was stent migration into the right atrium from inferior vena cava. Pleural bleeding was seen in 1 case (0.099%) and abdominal bleeding in 2 cases (0.199%). Two cases (0.199%) had pulmonary obstruction. A single (0.099%) case had chocolate cyst rupture in thrombolytic process. Twenty-seven patients had acute re-stenosis after the surgery, among which 22 (2.95%, 22/746) had the stenosis after only PTA and 5 (1.92%, 5/260) had the stenosis after receiving both PTA and stent. 3 (0.298%) cases had pseudoaneurysm at the puncturing site. Puncture site bleeding and local hematoma was seen in 10 cases (0.99%), whereas 4 cases (0.398%) had leg phlebothrombosis on the same side of the puncture site.
Conclusion: Interventional treatment is a safe and effective way to treat BCS. Various effective measures should be taken to avoid and lower the incidence of complications.