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Long-term outcomes of individualized treatment strategy in treatment of type I Budd-Chiari syndrome in 456 patients
- Source :
- Liver international : official journal of the International Association for the Study of the Liver. 39(8)
- Publication Year :
- 2019
-
Abstract
- Aim To evaluate individualized treatment strategy (ITS) and long-term outcomes of endovascular treatment of Budd-Chiari syndrome (BCS) with obstructed inferior vena cava (IVC) based on different degrees of hepatic vein (HV) involvement. Methods From January 2006 to June 2017, 456 consecutive patients with BCS with obstructed IVC underwent endovascular treatment with ITS. All patients received IVC recanalization. Then, 426 patients with at least one patent HV received no additional treatment. Twenty-fivepatients with membranous or segmental occlusion of HVs underwent HV recanalization and for the remaining five patients with diffuse HVs occlusion, a transjugular intrahepatic portosystemic shunt (TIPS) was performed. Results The endovascular treatment was technically successful in 455 of the 456 patients (99.8%). The complication rate was 5.0% (23/456), with major complications in 13 patients (2.8%) and minor complications in 10 patients (2.2%). Median follow-up time was 60.5 months (range, 4-120 months). The cumulative 1-, 2-, 5- and 10-year primary vessel patency rates were 93.6%, 89.9%, 80.5% and 74.3% respectively and the cumulative 1-, 2-, 5-, 10- year secondary patency rates were 99.8%, 99.8%, 98.2% and 97.2% respectively. The cumulative 1-, 2-, 5- and 10-year survival rates were 98.4%, 95.8%, 91.2% and 76.5% respectively. Illness duration and decreased serum albumin were independent predictors of survival. Conclusion The ITS for Asian BCS with obstructed IVC and varying degrees of HV involvement appears to be effective and with good long-term outcomes.
- Subjects :
- Adult
Male
medicine.medical_specialty
China
Adolescent
medicine.medical_treatment
Individualized treatment
Budd-Chiari Syndrome
Inferior vena cava
03 medical and health sciences
Young Adult
0302 clinical medicine
Angioplasty
Occlusion
medicine
Long term outcomes
Humans
Precision Medicine
Vein
Child
Aged
Retrospective Studies
Hepatology
business.industry
Middle Aged
medicine.disease
Surgery
medicine.anatomical_structure
Treatment Outcome
medicine.vein
030220 oncology & carcinogenesis
cardiovascular system
Budd–Chiari syndrome
030211 gastroenterology & hepatology
Female
business
Transjugular intrahepatic portosystemic shunt
Subjects
Details
- ISSN :
- 14783231
- Volume :
- 39
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Liver international : official journal of the International Association for the Study of the Liver
- Accession number :
- edsair.doi.dedup.....e1644bb43c292d83c22af8dac4d8cf55