Long‐term safety and outcome of percutaneous transhepatic venous balloon angioplasty for Budd–Chiari syndrome

• DOI: 10.1111/jgh.13025
• Publication Date: 2015-06-23T14:17:11Z
• Authors: Peng‐Xu Ding; Shui‐Jun Zhang; Zhen Li; Ming‐Ti Fu; Zhao‐Hui Hua; Wen‐Guang Zhang
• Keywords: Adult; Male; Time Factors; Adolescent; Hepatic Veno-Occlusive Disease; Budd-Chiari Syndrome; Hepatic Veins; Middle Aged; 3. Good health; Time; Survival Rate; Young Adult; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Asian People; Humans; Female; Safety; Angioplasty, Balloon; Aged; Follow-Up Studies; Retrospective Studies

AbstractBackground and AimsThe restenosis following percutaneous transluminal balloon angioplasty (PTBA) is high for Budd–Chiari syndrome (BCS) patients with hepatic venous obstruction (HVO). We aim to evaluate the safety and long‐term outcome of PTBA with a large balloon catheter in a large series of patients with HVO.MethodsBetween January 2005 and December 2013, 93 consecutive BCS patients with HVO were referred for PTBA and subsequently underwent color Doppler ultrasonography or angiography follow‐up. Data were retrospectively collected, and follow‐up observations were performed at 1‐, 2‐, 2‐ to 5‐, and 5‐ to 8‐years postoperatively.ResultsPercutaneous transluminal balloon angioplasty was technically successful in all patients. Ninety‐one patients (97.85%) were treated with PTBA and two with PTBA and stent. Major procedure‐related complications occurred in six of the 93 patients (6.45%). The cumulative 1‐, 2‐, 2‐ to 5‐, and 5‐ to 8‐year primary patency rates were 97.5%, 92.9%, 90%, and 86.5%, respectively. Cumulative 1‐, 2‐, 2‐ to 5‐, and 5‐ to 8‐year secondary patency rates were 100%, 100%, 98.6%, and 97.3%, respectively. Mean and median primary patency rates were 51.50 ± 3.01 months and 55.0 ± 3.63 months, respectively. Cumulative 1‐, 2‐, 2‐ to 5‐, and 5‐ to 8‐year survival rates were 98.75%, 98.6%, 100%, and 100%, respectively. Mean and median survival times were 53.10 ± 3.04 months and 55.0 ± 3.64 months, respectively.ConclusionPercutaneous transluminal balloon angioplasty with a large balloon is a safe and effective treatment that could provide excellent rates of long‐term patency and survival for the majority of Chinese patients with BCS and HVO.