Budd-Chiari syndrome: consensus guidance of the Asian Pacific Association for the study of the liver (APASL)

Shukla, Akash; Shreshtha, Ananta; Mukund, Amar; Bihari, Chhagan; Eapen, CE; Han, Guohong; Deshmukh, Hemant; Y., Ian Homer; Lesmana, Cosmas Rinaldi Adithya; Meshtab, Mamun Al; Kage, Masayoshi; Chaiteeraki, Roongruedee; Treeprasertsuk, Sombat; Giri, Suprabhat; Punamiya, Sundeep; Paradis, Valérie; Qi, Xingshun; Sugawara, Yasuhiko; Abbas, Zaigham; Sarin, Shiv Kumar

doi:10.1007/s12072-021-10189-4

Cited by 52 publications

(98 citation statements)

References 233 publications

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“…Membranous occlusion of the HV and/or inferior vena cava (IVC) is more common in Asian patients than in Western patients [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Shrestha et al suggested that MOVC is caused by bacteria-induced thrombophlebitis [ 14 ]. Mechanical disruption or stenting of the obstructed IVC and/or HVs may restore hepatic outflow, closely mimicking normal physiology [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Based on etiology, BCS is classified into primary which includes intravenous thrombosis, webs, and endophlebitis, and secondary which includes tumors, parasitic cysts (echinococcosis), and abscesses that compress the venous system [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…In particular, type A was characterized by pathological findings of acute HV thrombosis or blockage of the stenting device. In type B, non-thrombotic acute episodes trigger an acute-on-chronic episode in a chronic BCS, and in type C, acute HV thrombosis triggers acute chronic episodes in non-vascular chronic liver disease ( Table 4 ) [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…As with any other clinical entity similar to BCS, the need to quantify the disease severity and to identify patients at risk for disease progression, and increased morbidity and mortality make liver surgeons from the centers of excellence to develop prognostic indices. To date, there are five prognostic scores: the Clichy, New Clichy, Rotterdam, BCS-transjugular intrahepatic portosystemic shunt (TIPSS), and All India Institute of Medical Sciences Hepatic Venous Outflow Tract Obstruction (AIIMS-HVOVTO) scores ( Table 5 ) [ 11 , 42 - 45 ].…”

Section: Discussionmentioning

confidence: 99%

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State of the Art, Current Perspectives, and Controversies of Budd-Chiari Syndrome: A Review

et al. 2022

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Background Budd-Chiari syndrome (BCS) is an eponym that includes a group of conditions characterized by partial or complete hepatic venous tract outflow obstruction, and the site of obstruction may involve one or more hepatic veins, inferior vena cava, or the right atrium. The classification of BCS is based on etiology, site of obstruction, and duration. Its etiology is very heterogeneous; in particular, hepatic vein thrombosis is the most common type of obstruction and myeloproliferative disorder, the most common thrombophilic disorder, in the West. In Asian countries, the type of obstruction, thrombophilic disorders, clinical features, and treatment strategies vary widely from region to region. Although the cause can be identified in 90% of patients with the help of gene mutation testing, BCS remains under-recognized in many countries. A higher prevalence of acute cases has been reported in the West than in the East. This global and regional heterogeneity raises several challenges regarding the evaluation, management strategy, and individualized approach of BCS. This study aimed to conduct a systematic review of BCS to elucidate treatment strategy options. Methods PubMed, Embase, Cochrane Library, and Google Scholar databases were searched systematically. Results Sixty-nine pertinent articles were retrieved and included in the present study. Conclusions Further research on the following three topics would help define individualized treatment strategies. The first is a better understanding of the molecular pathways underlying the thrombophilic conditions implicated in the pathogenesis of BCS. The second is the role of the genotype and gene mutations in the determination of coagulation status of patients with BCS. The third is the definition of clear criteria and development of a common prognostic index to risk stratify the patients at presentation and consequently detect candidates for invasive therapies.

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“…Membranous occlusion of the HV and/or inferior vena cava (IVC) is more common in Asian patients than in Western patients [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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State of the Art, Current Perspectives, and Controversies of Budd-Chiari Syndrome: A Review

et al. 2022

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Budd‐Chiari syndrome in children: Radiological intervention and role of shear wave elastography in monitoring response

Samanta,

Srivastava,

Yadav

et al. 2023

J. pediatr. gastroenterol. nutr.

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ObjectivesRadiological intervention (RI) is the preferred treatment in children with Budd‐Chiari syndrome (BCS). We studied the comparative long‐term outcome of BCS children, with and without RI and utility of liver and splenic stiffness measurement (LSM, SSM) by 2‐dimensional shear wave elastography (2D‐SWE) in assessing response.MethodsSixty children (40 boys, median age 10.5 [6.5–15.25] years) with BCS (29 newly diagnosed, 31 follow‐up) were evaluated. LSM and SSM by 2D‐SWE and vascular patency were monitored pre‐ and postprocedure (≥ 6 months postprocedure) in those undergoing RI. Medical therapy without anticoagulation and monitoring was done in subjects without RI. The RI and no‐RI groups were compared.ResultsAscites (54,90%), hepatomegaly (56,93%) and prominent abdominal‐veins (42,70%), were the commonest features. The majority (46,78%) had isolated hepatic vein block. 44 (73%) cases underwent RI, while 16 (27%) were managed conservatively. Both groups were similar at baseline. Post‐RI subjects showed significant improvement in clinical findings, liver functions and portal hypertension. LSM [33 (32–34.5) to 19.2 (18–20.67) kPa] and SSM [54.5 (52.3–57.6) to 28.9 (27.6–30.25) kPa] showed a significant decline from baseline value over a follow‐up of 12 (6–13) months. Gradual reduction occurred in the LSM and SSM over 1–5 years, with near‐normal LSM [10.2 (9.2–11.5) kPa] and SSM [22.3 (20.5–24.3) kPa] values in patients (n‐16) with > 5 years follow‐up. Patients without RI showed worsening in LSM and SSM. Hepatopulmonary syndrome and hepatocellular carcinoma developed in 4 (8%) and 1 (1.7%) cases respectively.ConclusionRI leads to clinical recovery and reduction with near normalization of LSM and SSM over long‐term follow‐up in children with BCS. 2D‐SWE is a promising tool to monitor outcomes.

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Interventions in Budd-Chiari syndrome: an updated review

Patel,

Chandel,

Tripathy

et al. 2024

Abdom Radiol

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Budd-Chiari syndrome: consensus guidance of the Asian Pacific Association for the study of the liver (APASL)

Cited by 52 publications

References 233 publications

State of the Art, Current Perspectives, and Controversies of Budd-Chiari Syndrome: A Review

State of the Art, Current Perspectives, and Controversies of Budd-Chiari Syndrome: A Review

Budd‐Chiari syndrome in children: Radiological intervention and role of shear wave elastography in monitoring response

Interventions in Budd-Chiari syndrome: an updated review

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