To restrict indication for stenting of the inferior vena cava and liver transplantation in patients with Budd-Chiari syndrome |
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Authors: | Wang Zhonggao |
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Institution: | (1) Vascular Institute & Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China |
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Abstract: | The Budd-Chiari syndrome (BCS) used to be a very rare disorder and lacked a means of relieving. However, various shuntings
and radical procedures have emerged in the last three decades with quite encouraging outcomes. Recent minimally invasive therapies,
such as stenting of the inferior vena cava (IVC), are simple and easy to handle. However, it has been realized that the IVC
stent may compromise the hepatic veins and cause catastrophic consequences, thus the indication for IVC stenting should be
reevaluated and especially not to be overused. Instead, it should be applied by percutaneous transangiography (PTA) only,
which may be repeated when necessary. The BCS in China predominantly belongs to the IVC type rather than the intrahepatic
type in Western; the outcome from its conventional therapy, at least for the moment, is better than that of liver transplantation.
It is thus suggested that, before liver transplantation is decided, the conventional means for managing BCS be considered.
The final suggestion is to restrict the indication both for stenting of the IVC and liver transplantation. In this paper,
ten examples are given with figures. |
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Keywords: | Budd-Chiari syndrome stenting shunting liver transplantation inferior vena cava ascites hematemesis PTA |
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