Clinical outcomes of large diameter balloon angioplasty for Budd-Chiari syndrome with inferior vena cava involvement

Abstract

ObjectiveWe compared the long-term outcomes of small and large diameter balloon angioplasty for Budd-Chiari syndrome (BCS) with inferior vena cava (IVC) involvement in a retrospective cohort study. MethodsOf 119 patients with BCS and IVC involvement, 23 had undergone small diameter balloon angioplasty (diameter, 14-20 mm; group A) and 96 had undergone large diameter balloon angioplasty (diameter, 24-30 mm; group B). The patients were considered cured clinically if the IVC was patent with no symptom or signs evident. ResultsFrom January 2010 to December 2016, 119 BCS patients with IVC involvement had undergone balloon angioplasty, with angioplasty successful in all 119 patients. One patient died of pulmonary embolism after dilation in group A. Abdominal pain was the most common complication during dilation and was experienced by significantly more patients in group B (77.1%) than in group A (47.8%; P = .009). Of the 119 patients, 91 (76.5%) were considered cured, with significantly more patients in group B (82.3%) than in group A (52.2%; P = .005). The mean follow-up period was 41.3 ± 2.2 months. In group B, the 1-, 3-, and 5-year primary and secondary patency rates were 82.2% ± 4.2%, 69.8% ± 5.4%, and 54.0% ± 7.0% and 97.5% ± 1.7%, 92.5% ± 3.3%, and 90.2% ± 3.9%, respectively. The patency rates at all follow-up intervals were lower in group A than in group B. The clinical response rate in group B was also significantly greater than that in group A (96.9% vs 78.3%; P = .007). The 1-, 3-, and 5-year survival rates were 100%, 88.7% ± 7.6%, and 88.7% ± 7.6% and 96.5% ± 2.0%, 92.5% ± 3.0%, and 86.0% ± 5.4% in groups A and B, respectively. ConclusionsLarge diameter balloon angioplasty is safe and effective for BCS patients with IVC involvement, yielding better patency rates and long-term outcomes compared with small diameter balloon angioplasty.