Budd-Chiari Syndrome: Hepatic Venous Web Outflow Obstruction Treated by Percutaneous Placement of Hepatic Vein Stent

ABSTRACT

Budd-Chiari syndrome (BCS) denotes a heterogeneous group of diseases characterized by hepatic venous outflow obstruction at the level of the hepatic veins or inferior vena cava resulting in portal hypertension. Traditional approach to treatment of BCS involves systemic thrombolysis and surgical portosystemic shunt or transjugular intrahepatic portosystemic shunt in progressive cases of BCS or as a bridge to transplantation. Recently, an increasing number of successful reports of BCS therapy have involved endovascular techniques, including angioplasty and stent placement. The present report illustrates successful percutaneous recanalization of complete hepatic vein occlusion by angioplasty and stent implantation in a patient with membranous obstruction.

Budd-Chiari syndrome - hepatic vein obstruction - hepatic vein stent - inferior vena cava stenosis - endovascular treatment

SUGGESTED READINGS

• 1 Bargallo X, Gilabert R, Nicolau C, Garcia-Pagan J C, Ayuso J R, Bru C. Sonography of Budd-Chiari syndrome.  AJR Am J Roentgenol. 2006;  187 W33-W41
• 2 Bogin V, Marcos A, Shaw-Stiffel T. Budd-Chiari syndrome: in evolution.  Eur J Gastroenterol Hepatol. 2005;  17 33-35
• 3 Bozkurt G, Cil B, Akbay A, Turk C C, Palaoglu S. Intractable radicular and low back pain secondary to inferior vena cava stenosis associated with Budd-Chiari syndrome: endovascular treatment with cava stenting-case report and review of the literature.  Spine. 2006;  31 E383-E386
• 4 Desser T S, Sze D Y, Jeffrey R B. Imaging and intervention in the hepatic veins.  AJR Am J Roentgenol. 2003;  180 1583-1591
• 5 Erden A, Erden I, Karayalcin S, Yurdaydin C. Budd-Chiari syndrome: evaluation with multiphase contrast-enhanced three-dimensional MR angiography.  AJR Am J Roentgenol. 2002;  179 1287-1292
• 6 Janssen H L, Garcia-Pagan J C, Elias E et al.. Budd-Chiari syndrome: a review by an expert panel.  J Hepatol. 2003;  38 364-371
• 7 Kage M, Arakawa M, Kojiro M, Okuda K. Histopathology of membranous obstruction of the inferior vena cava in Budd-Chiari syndrome.  Gastroenterology. 1992;  102 2081-2090
• 8 Kavanagh P M, Roberts J, Gibney R, Malone D, Hegarty J, McCormick P A. Acute Budd-Chiari syndrome with liver failure: the experience of a policy of initial interventional radiological treatment using transjugular intrahepatic portosystemic shunt.  J Gastroenterol Hepatol. 2004;  19 1135-1139
• 9 Lee B B, Villavicencio L, Kim Y W et al.. Primary Budd-Chiari syndrome: outcome of endovascular management for suprahepatic venous obstruction.  J Vasc Surg. 2006;  43 101-108
• 10 Mahmoud A E, Mendoza A, Meshikhes A N et al.. Clinical spectrum, investigations and treatment of Budd-Chiari syndrome.  QJM. 1996;  89 37-43
• 11 Menon K V, Shah V, Kamath P S. The Budd-Chiari syndrome.  N Engl J Med. 2004;  350 578-585
• 12 Rerksuppaphol S, Hardikar W, Smith A L et al.. Successful stenting for Budd-Chiari syndrome after pediatric liver transplantation: a case series and review of the literature.  Pediatr Surg Int. 2004;  20 87-90
• 13 Sanchez-Recalde A, Sobrino N, Galeote G, Calvo Orbe L, Merino J L, Sobrino J A. Budd-Chiari syndrome with complete occlusion of the inferior vena cava: percutaneous recanalization by angioplasty and stenting.  Rev Esp Cardiol. 2004;  57 1121-1123
• 14 Sharma S, Texeira A, Texeira P, Elias E, Wilde J, Olliff S P. Pharmacological thrombolysis in Budd Chiari syndrome: a single centre experience and review of the literature.  J Hepatol. 2004;  40 172-180
• 15 Zhang C Q, Fu L N, Zhang G Q et al.. Long-term effect of stent placement in 115 patients with Budd-Chiari syndrome.  World J Gastroenterol. 2003;  9 2587-2591