INTERVENTIONAL THERAPEUTIC TECHNIQUES IN BUDD-CHIARI SYNDROME

Purpose: To analyze the results obtained with percutaneous therapeutic procedures in patients with Budd-Chiari syndrome (BCHS). Methods: Bet ween August 1991 and April 1993, seven patients with BCHS were treated in our hospital. Three presented with a congenital web; in another th ree cases the hepatic veins and/or the inferior vena cava (IVC) were c ompromised after major hepatic surgery; one patient presented with a s evere stenosis of the intrahepatic IVC due to hepatomegaly. Results: O ne of the patients with congenital web has required several new dilata tions due to restenosis; one patient required a transjugular intrahepa tic portosystemic shunt procedure while awaiting a liver transplantati on. The two postsurgical patients with stenosed hepatic veins did not require any new procedure after the placement of metallic endoprosthes es, However, the patient with liver transplantation presented IVC rest enosis after balloon angioplasty that required the deployment of metal lic endoprostheses, In the patient with hepatomegaly a self-expandable prosthesis was placed in the intrahepatic portion of the IVC before ( 4 months) a liver transplantation. Conclusion: Interventional therapeu tic techniques offer a wide variety of possibilities for the treatment of patients with BCHS. For IVC stenoses, the results obtained with ba lloon angioplasty are at least as good as those obtained with surgery.