Hepatic venous outflow tract obstruction: treatment outcomes and development of a new prognostic score

• DOI: 10.1111/apt.13604
• Publication Date: 2016-04-10T17:36:27Z
• Authors: Shalimar; A. Kumar; S. Kedia; H. Sharma; S. R. Gamanagatti; G. S. Gulati; B. Nayak; B. Thakur; S. K. Acharya
• Keywords: Outflow

Results of endovascular interventions in hepatic venous outflow tract obstruction (HVOTO) have been reported from limited studies. Treatment outcomes and prognostic scores need further validation.To evaluate treatment for an Indian population.Consecutive patients with diagnosed at a tertiary centre were included. Technical success clinical response after interventional therapy documented. Predictors survival assessed Cox-proportional model. A new score was derived the factors significant on multivariate analysis compared Child-Turcotte-Pugh, model end-stage liver disease (MELD), Rotterdam index (PI) Budd-Chiari syndrome-transjugular intrahepatic portosystemic shunt ( BCS-TIPSS) PI.Three hundred thirty-four (56.6% males), median age 24 (3-62) years Hepatic vein commonest site block-isolated vonous block 48%, combined venous-inferior vena cava 46%. Endovascular performed 233/334 (70%) 90% technical success. Clinical complete 166 (71.2%), partial 58 (24.9%) no nine (3.9%). Majority cases HV did not require TIPSS could be treated angioplasty (with/without stenting). On analysis, Child class C to intervention independent predictors outcome used derive All India Institute Medical Sciences (AIIMS) score. The 5-year 92% (95% CI, 81-97%) ≤3, 79% (95%CI, 63-88%) >3 ≤4, 39% 21-57%) >4. performance AIIMS superior other indices.Advanced are associated poor outcomes. predicts better than scores.