Restenosis after recanalization for Budd-Chiari syndrome: Management and long-term results of 60 patients

Table 1 Baseline characteristics of 60 patients with stenosis after recanalization

	PTA alone (n = 40)	PTA + stent (n = 20)
Demographic data
Male	22 (55%)	18 (90%)
Female	18 (45%)	2 (10%)
Age (yr)1	36 (14-68)	37 (15-80)
Duration of symptoms
≤ 1 mo	7 (17.5%)	4 (20%)
1-6 mo	6 (15%)	6 (30%)
≥ 6 mo	27 (67.5%)	10 (50%)
Clinical manifestations
Abdominal distention	18 (45%)	9 (45%)
Abdominal wall varicosis	21 (52.5%)	11 (55%)
Lower-extremity edema	22 (55%)	13 (65%)
Gastroesophageal variceal bleeding	3 (7.5%)	6 (30%)
Laboratory tests1
Hemoglobin level (g/L)	130 (65-180)	134 (80-168)
Platelet count (× 109/L)	105 (46-306)	130 (33-209)
Alanine transaminase level (× ULN)	0.6 (0.2-28)	0.6 (0.2-13)
Albumin level (g/L)	38 (22-50)	36 (26-58)
Total bilirubin level (μmol/L)	29 (11-132)	29 (8-148)
International normalized ratio	1.3 (1.0-1.9)	1.4 (0.9-2.9)
Creatinine level (μmol/L)	66 (41-254)	79 (33-157)
Imaging features
Type of obstruction
HV	8 (20%)	1 (5%)
IVC	5 (12.5%)	6 (30%)
Com	27 (67.5%)	13 (65%)
Pattern of IVC obstruction
No obstruction	8 (20%)	1 (5%)
Membranous	30 (75%)	9 (45%)
Segmental	2 (5%)	2 (10%)
Long segmental	0 (2.5%)	8 (40%)
Ascites	17 (42.5%)	11 (55%)
AHV compensatory	7 (17.5%)	5 (25%)
IVC thrombosis	11 (27.5%)	11 (55%)
Prognostic index
Child-Pugh score1	7 (5-11)	7 (5-11)
Child-Pugh class
A	18 (45%)	4 (20%)
B	20 (50%)	12 (60%)
C	2 (5%)	4 (20%)

Except where indicated, data are shown as numbers of patients.

¹Data are medians with ranges in parentheses. ULN: Upper limit of normal; HV: Hepatic vein; IVC: Inferior vena cava; Com: Combination; AHV: Accessory hepatic vein.

Table 2 Detailed information regarding the management and outcomes of 60 Budd-Chiari syndrome patients with restenosis

Primary recanalization	Management	Death	Remission	Non-remission
PTA alone 40	PTA alone 19 (47.5%)	HCC 2 (5%), variceal bleeding 2 (5%), liver or multiple organ failure 1 (2.5%)	14 (35%)	0
	PTA + stent 8 (20%)	HCC 1 (2.5%), liver or multiple organ failure 1 (2.5%), intracranial hemorrhage induced by hypertension 1 (2.5%), accidental death 1 (2.5%)	4 (10%)	0
	Untreated 13 (32.5%)	Liver or multiple organ failure 5 (12.5%), variceal bleeding 1 (2.5%), DIC 1 (2.5%)	2 (5%)	Abdominal distension 3 (7.5%), lower-extremity edema 1 (2.5%)
PTA + stent 20	PTA alone 10 (50%)	Liver or multiple organ failure 1 (5%)	9 (45%)	0
	PTA + stent 1 (5%)	0	1 (5%)	0
	Untreated 9 (45%)	HCC 1 (5%), variceal bleeding 2 (10%), liver or multiple organ failure 4 (20%), hepatic encephalopathy 2 (10%)	0	0

BCS: Budd-Chiari syndrome; PTA: Percutaneous transluminal angioplasty; HCC: Hepatocellular carcinoma; DIC: Disseminated intravascular coagulation.