Acute Budd-Chiari syndrome with liver failure: the experience of a policy of initial interventional radiological treatment using transjugular intrahepatic portosystemic shunt

Journal of Gastroenterology and Hepatology
Paul M KavanaghP Aiden McCormick

Abstract

The optimal management of acute Budd-Chiari syndrome (BCS) with liver failure is controversial. Options include anticoagulation, portal systemic shunting or liver transplantation. In recent years, transjugular intrahepatic portosystemic shunts (TIPS) have been tried in place of shunt surgery. We report our experience with a policy of initial interventional radiological treatment (TIPS) in this patient group. A consecutive, non-selected series of five patients with acute BCS with liver failure presenting to our liver unit over a 36-month period from October 2000 were treated with a policy of initial attempt at transjugular shunt. Stents were successfully inserted in four patients. In one patient the hepatic vein remnant could not be cannulated. One of the four stented patients had a hepatic venous web. Rapid recurrent portal and hepatic vein thrombosis occurred in one patient despite anticoagulation and trans-shunt thrombectomy. This patient and the patient with failed stenting underwent successful liver transplantation. One successfully stented patient died unexpectedly at home 2 weeks after TIPS insertion. Four of five patients are alive (80%) at a mean follow-up time of 30 months. Initial TIPS, with liver transplantation for ...Continue Reading

References

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Sep 27, 2003·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Dominique-Charles Valla

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Citations

May 27, 2006·Cardiovascular and Interventional Radiology·A QuateenJ Ricke
Jan 25, 2008·Cardiovascular and Interventional Radiology·David Beckett, Simon Olliff
Mar 1, 2007·Seminars in Interventional Radiology·Alireza BozorgmaneshJames G Caridi
Jan 12, 2008·World Journal of Gastroenterology : WJG·Deepak N AmarapurkarNikhil D Patel
Jul 19, 2013·Cardiovascular and Interventional Radiology·Katerina FitsioriElias Brountzos
Feb 24, 2016·Journal of Clinical and Experimental Hepatology·Harshad Devarbhavi, Arvind R Murali
Nov 29, 2015·Journal of Vascular and Interventional Radiology : JVIR·Sean R DariushniaUNKNOWN Society of Interventional Radiology Standards of Practice Committee
Apr 29, 2009·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Laurie D DeLeveUNKNOWN American Association for the Study Liver Diseases
Jan 24, 2006·Journal of Hepatology·Gilles MenthaJuergen Klempnauer
Oct 16, 2016·Journal of Pediatric Gastroenterology and Nutrition·Riad LutfiGirish Subbarao
Oct 20, 2006·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Andrew S Klein
Oct 13, 2006·European Journal of Gastroenterology & Hepatology·Simon P Olliff
Dec 15, 2012·Expert Review of Gastroenterology & Hepatology·Ross MacNicholasDhiraj Tripathi

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