Successful treatment of Budd-Chiari Syndrome with Balloon Dilatation Angioplasty

Abstract

A 62-year-old woman was admitted because of prolonged jaundice. After examination of contrast enhanced computed tomography images, she was diagnosed with Budd-Chiari syndrome due to a short obstruction of the hepatic portion of the inferior vena cava. She received endovascular angioplasty using a catheter with a balloon 14 mm in diameter. After balloon dilatation angioplasty of the obstructed inferior vena cava, favourable antegrade blood flow was restored. Then, oral warfarin therapy was started to prevent restenosis by thrombus formation. Contrast-enhanced computed tomography images taken four months after treatment revealed no restenosis of the inferior vena cava. This report is significant because it presents an effective and minimally invasive strategy for treating Budd-Chiari syndrome. Balloon dilatation angioplasty should be considered as the first choice of treatment if an obstruction is short and located in the major trunk of the hepatic vein or inferior vena cava.

Budd chiari syndrome: A case report on a rare disorder

“…In our case, there was no way to include DIPS in a stent, so our patient underwent mesocaval shunt surgery. Another patient in that case series had a factor 5 Leiden mutation that leads to progressive liver dysfunction which requires liver transplantation [11], similarly, our patient was also suggested for transplantation. Moreover, the third case used oral contraceptives that lead to BCS, but in this case, the patient did not use any contraceptive pills [11].…”

“…Another patient in that case series had a factor 5 Leiden mutation that leads to progressive liver dysfunction which requires liver transplantation [11], similarly, our patient was also suggested for transplantation. Moreover, the third case used oral contraceptives that lead to BCS, but in this case, the patient did not use any contraceptive pills [11]. When shunting is not practicable or in fulminant situations, liver transplantation is the best alternative [10].…”

“…The obstruction's location, length, and the patient's physical condition can achieve a 95% 5-year survival in chronic cases by surgical shunt [10]. Tomita et al reported three cases of BCS, one of which had subacute and handled with the transjugular intrahepatic portosystemic shunt [11]. In our case, there was no way to include DIPS in a stent, so our patient underwent mesocaval shunt surgery.…”