Recanalization of accessory hepatic vein for hepatic vein-type Budd–Chiari syndrome

• Published in: Abdominal imaging Vol. 46; no. 7; pp. 3456 - 3463
• Main Authors: Lv, Lu-Lu, Zhu, Li-Li, Chen, Gao-Hong, Xu, Peng, Xu, Kai
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2021; Springer Nature B.V
• Subjects: Gastroenterology; Hepatic vein; Hepatology; Imaging; Interventional Radiology; Liver; Liver diseases; Medicine; Medicine & Public Health; Patients; Radiology; Surgical outcomes; Survival; Vascular surgery; Vein & artery diseases; Long-term outcomes; Budd–Chiari syndrome; Percutaneous recanalization; Hepatic vein
• ISSN: 2366-004X; 2366-0058
• DOI: 10.1007/s00261-021-02977-1

Objective To evaluate the clinical efficacy and long-term outcomes associated with the treatment of hepatic vein (HV)-type Budd–Chiari syndrome (BCS) via accessory HV (AHV) recanalization. Methods In total, 26 HV-type BCS patients underwent AHV recanalization between July 2014 and December 2019 at our hospital, while 73 HV-type BCS patients without compensatory AHV underwent main HV (MHV) recanalization and served as controls in the present study. Short- and long-term clinical outcomes were compared. Results AHV and MHV recanalization approaches were both associated with 100% technical success rates, with one recanalization procedure being performed per patient. Respective clinical success rates for the AHV and MHV recanalization approaches were 96.2% and 94.5% ( P  = 0.744). Re-obstruction rates were comparable between these two approaches at 20% and 34.8%, respectively ( P  = 0.17). Primary cumulative 1-, 2-, and 5-year patency rates in the AHV group were 96.0%, 91.6%, and 76.3%, respectively, whereas in the MHV group, these three respective rates were 87.0%, 78.6%, and 58.6% ( P  = 0.048). Secondary cumulative 1-, 2-, and 5-year patency rates in the AHV group were 96.0%, 96.0%, and 96.0%, respectively, whereas in the MHV group, they were 97.1%, 97.1%, and 81.8%, respectively ( P  = 0.289). Cumulative 1-, 2-, and 5-year survival rates for AHV group patients were 96.0%, 96.0%, and 96.0%, respectively, while for the MHV group, these respective rates were 98.6%, 95.2%, and 89.7% ( P  = 0.462). Conclusion HV-type BCS can be safely and effectively treated via AHV recanalization, which may achieve longer patency relative to MHV recanalization.