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Scientific article
English

Transjugular intrahepatic portosystemic shunt for the treatment of Budd-Chiari syndrome patients : results from a single center

Published inCardiovascular and interventional radiology, vol. 37, no. 3, p. 691-697
Publication date2014-06
First online date2013-07-17
Abstract

Purpose: To evaluate the outcome of transjugular intrahepatic portosystemic shunt (TIPS) in patients with Budd-Chiari syndrome (BCS).

Patients and methods: Fourteen patients (11 female, mean age 45.8 years), with symptomatic BCS refractory to conventional therapy, were treated with TIPS placement in our department within a period of 9 years. Stent grafts were primarily used in 12 patients. Mean follow-up time was 38.1 ± 36.1 months (range 7-114). Model for end-stage liver disease (MELD) score, BCS Rotterdam index, and Child-Pugh score were calculated for all patients. In addition, the recently suggested BCS-TIPS prognostic index score (BSC-TIPS PI) was applied.

Results: BCS-TIPS PI score was ≤7 in all patients. Most of our patients (12 of 14) had good or intermediate prognosis according to MELD, Rotterdam and Child-Pugh scores. Technical success was achieved in all 14 patients and was accompanied by complete resolution of the symptoms. In 3 patients, the procedure was complicated by hemoperitoneum, which was successfully treated in two patients with coils or stent-graft placement, whereas 1 patient was managed in the operating room. Thirteen patients are symptom and orthotopic liver transplantation-free. Primary patency was 92.8, 84.7, and 58.7 % at 6, 12, and 24 months, respectively. Secondary patency was 100, 100 and 84.6 % at 6, 12, and 24 months respectively.

Conclusion: In symptomatic BCS patients with moderate prognosis according to MELD, Child-Pugh, and BCS Rotterdam scores, as well as BCS-TIPS PI score ≤7, TIPS has high clinical success, low morbidity, and no mortality, and it offers durable mid-term resolution of the symptoms and OLT-free survival.

eng
Keywords
  • Adult
  • Budd-Chiari Syndrome / diagnosis
  • Budd-Chiari Syndrome / surgery
  • Diagnostic Imaging
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Portasystemic Shunt, Transjugular Intrahepatic
  • Prognosis
  • Retrospective Studies
  • Stents
  • Treatment Outcome
  • Vascular Patency
Affiliation Not a UNIGE publication
Citation (ISO format)
FITSIORI, Aikaterini et al. Transjugular intrahepatic portosystemic shunt for the treatment of Budd-Chiari syndrome patients : results from a single center. In: Cardiovascular and interventional radiology, 2014, vol. 37, n° 3, p. 691–697. doi: 10.1007/s00270-013-0697-9
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ISSN of the journal0174-1551
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