The Outcome Of Long-term Observation Of Patients With Budd-Chiari Syndrome After Endovascular Treatment

Aim:To observe the long-term outcome of patients with Budd-Chiari syndrome after endovascular treatmentMethods:We retrospectively analyzed 599 patients with Budd-Chiari syndrome who accepted endovascular treatment in Provincial hospital affiliated to Shandong university during January 1994 to December 2016,and followed up 154 of these patients.Patients who met the standards of inclusion and exclusion criteria were measured and recorded the baseline values of clinical indexes.Dividing by different classification methods and prognostic score,we compared the survival and patent rate among the groups and explored the related factors which would cause the difference.Results:1.After IVC PTA or PTA+stent,the pressure of IVC was reduced from 18.45+6.93mmHg to 12.76±5.03mmHg(P<0.05).After HV PTA or PTA+stent,the hepatic venous pressure was decreased from 25.93 1 8.61mmHg to 14.3415.77mmHg(P<0.05).2.There were no significant difference among patients with different types(IVC,HV,IVC + HV),prognostic score(Child Pugh score,MELD score,Rotterdam score,Clichy score),endovascular treatment methods(IVC/HV PTA,PTA+stent,TIPSS)when comparing with the 1-,3-,5-and 10-years cumulative survival rate(P>0.05);The difference of long-term outcomes of PTA versus PTA+stents was not significant in each group.3.There were no significant difference among patients with different types(IVC,HV,IVC + HV),prognostic score(Child Pugh score,MELD score,Rotterdam score,Clichy score),endovascular treatment methods(IVC/HV PTA,PTA+stent,TIPSS)when comparing with the 1-,3-,5-and 10-years cumulative patent rate(P>0.05);The difference of long-term patent rate of PTA versus PTA+stents was not significant in each group.4.We analyzed the clinical indexes by One-Way ANOVA,which showed that Cr,GGT and ALP were correlated with survival rate of BCS patients who accepted the endovascular treatment;Logistic analysis and Cox regression analysis only suggested that Cr was associated with survival rate(P<0.05).5.We analyzed the clinical indexes by One-Way ANOVA and multi-factor analysis,the results all showed that D-dimer was correlated with patent rate of BCS patients who accepted the endovascular treatment,which suggested that D-dimer could be an important predictor of vascular patency(P<0.05).6.The recurrence may be related to BCS classification(HV type),which account for higher rate between patents who would need reintervention;For T-test,WBC was the only factor which may be correlated with recurrence rate(P<0.05).Conclusion:1.There are high survival rate among patients with different types(IVC,HV,IVC ＋HV),prognostic score(Child Pugh score,MELD score,Rotterdam score,Clichy score),endovascular treatment methods(IVC/HV PTA,PTA+stent,TIPSS);PTA and PTA+stents can all improve survival rate significantly.2.Patients with Budd-Chiari syndrome who accepted endovascular treatment have considerable cumulative patent rates.PTA and PTA+stents are not significant in improving patent rate in each groups.3.Cr,GGT and ALP are correlated with survival rate of BCS patients who accepted the endovascular treatment;Cr has a high prognostic rate comparing other clinical indexeses.4.D-dimer is correlated with survival rate of BCS patients who accepted the endovascular treatment,which is suggested a prognostic index for patent rate.5.The recurrence may be related to BCS classification(HV type);WBC may have prognostic value for recurrence rate.