Synchronous double- balloon dilation under guide-wire loop in interventional therapy of Budd-Chiari syndrome caused by hepatic vein obstruction

Abstract

Objective To investigate the value of double- balloon dilation synchronously under guide-wire loop in interventional therapy of patients with Budd-Chiari syndrome with hepatic vein obstruction. Methods A retrospective study was conducted on 5 patients admitted to the Affiliated Hospital of Xu Zhou Medical College with Budd-Chiari syndrome caused by hepatic vein obstruction from August 2012 to June 2015. There were 2 cases of combination stenosis of hepatic veins(HV) and accessory hepatic veins (AHV), 2 cases of HV occlusion with AHV stenosis, 1 case of HV stenosis with AHV occlusion. The technique of double-balloon dilatated synchronously under guide-wire loop was used in 5 patients by jugular vein-hepatic vein-accessory hepatic vein-femoral vein. The veinous pressure in HV and AHV was measured before and after treatment. Results 5 patients were treated successfully. No complications of bleeding, liver capsule hemorrhage, balloon rupture, pericardial tamponade and pulmonary embolism were observed. After the treatment, the pressure of the hepatic vein decreased from (32.4±2.2)cmH2O to(18.6±2.7)cm H2O (t=19.51, P<0.05); The symptoms and physical signs of B-C syndrome relieved or disappeared. BCS-related symptoms reappeared on follow-up in 1 patient and treated successfully. Conclusion The technique of double- balloon dilatated synchronously under guide-wire loop in interventional therapy of patients with Budd-Chiari syndrome with HV and AHV obstruction is safe and effective. Key words: Budd-Chiari syndrome; Balloon dilation; Hepatic veins