Stenting of Inferior Right Hepatic Vein in a Patient with Budd-Chiari Syndrome: A Case Report

• DOI: 10.1272/jnms.jnms.2023_90-603
• Publication Date: 2023-06-01T22:14:50Z
• Authors: Tetsuya Shimizu; Masato Yoshioka; Junji Ueda; Mampei Kawashima; Toshiyuki Irie; Yoichi Kawano; Akira Matsushita; Nobuhiko Taniai; Yasuhiro Mamada; Hiroshi Yoshida
• Keywords: Budd–Chiari syndrome; Balloon dilation; Hepatic veins

A Japanese man in his 20s was referred to our hospital with a two-month history of abdominal fullness and leg edema. Abdominal computed tomography revealing massive ascites ostial blockage the main hepatic veins, angiographic evaluation demonstrating obstruction veins yielded diagnosis Budd-Chiari syndrome (BCS). Diuretic agents were prescribed for but failed provide relief. The patient department further treatment. Angiography showed most portal flow draining from an inferior right vein (IRHV) into vena cava (IVC) thorough intrahepatic venous venovenous shunt. Access between IVC impossible, cannulation IRHV achieved. Because connection IRHV, metallic stents placed two IRHVs decrease congestion outflow. After stent placement followed by balloon expansion, gradient pressure improved remarkably. lower edema postoperatively, long-term patency (6 years)