Journal of gastroenterology and hepatology · 2018
Comparison of retrievable stents and permanent stents for Budd-Chiari syndrome due to obstructive inferior vena cava.
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Bi Yonghua, Chen Hongmei, Ding Pengxu, Ren Jianzhuang, Han Xinwei
Аннотация
BACKGROUND AND AIM: The aim of this study is to compare long-term outcomes of retrievable stents (RSs) and permanent stents (PSs) for Budd-Chiari syndrome (BCS) due to long-segment obstructive inferior vena cava (IVC).
METHODS: Between July 2000 and August 2016, 42 patients with BCS due to long-segment obstructive IVC were treated with RSs, and 41 patients were treated with PSs. The RSs were removed eventually after thrombus disappeared. Patients were subsequently followed up by color Doppler sonography or computed tomography scanning.
RESULTS: All RS placements were successful, and 37 RSs were retrieved 8 to 29 days later. Forty-two stents were implanted in PS group. One failure retrieval of RSs occurred, and two failures of cannulations were found in PS group. Two deaths may be procedure related and died from acute pulmonary thromboembolism perioperatively. One patient developed acute cerebral infarction and recovered after treatment. In PS group, minor complications were found in three patients. The length of IVC lesion segment and length and thickness of IVC thrombus decreased significantly, and diameter of retrocaval IVC and diaphragm IVC increased significantly in both groups. During follow-up, three patients died from liver failure in RS group, and two patients died in PS group. RS group showed a significantly higher primary patency rate than PS group. Cumulative 1-, 3-, and 5-year secondary patency rates were 95.2%, 89.6%, and 89.6% in RS group and 100%, 96.6%, and 96.6% in PS group (P = 0.7109).
CONCLUSIONS: Retrievable stents are effective for BCS because of long-segment obstructive IVC, with a higher primary patency rate.
METHODS: Between July 2000 and August 2016, 42 patients with BCS due to long-segment obstructive IVC were treated with RSs, and 41 patients were treated with PSs. The RSs were removed eventually after thrombus disappeared. Patients were subsequently followed up by color Doppler sonography or computed tomography scanning.
RESULTS: All RS placements were successful, and 37 RSs were retrieved 8 to 29 days later. Forty-two stents were implanted in PS group. One failure retrieval of RSs occurred, and two failures of cannulations were found in PS group. Two deaths may be procedure related and died from acute pulmonary thromboembolism perioperatively. One patient developed acute cerebral infarction and recovered after treatment. In PS group, minor complications were found in three patients. The length of IVC lesion segment and length and thickness of IVC thrombus decreased significantly, and diameter of retrocaval IVC and diaphragm IVC increased significantly in both groups. During follow-up, three patients died from liver failure in RS group, and two patients died in PS group. RS group showed a significantly higher primary patency rate than PS group. Cumulative 1-, 3-, and 5-year secondary patency rates were 95.2%, 89.6%, and 89.6% in RS group and 100%, 96.6%, and 96.6% in PS group (P = 0.7109).
CONCLUSIONS: Retrievable stents are effective for BCS because of long-segment obstructive IVC, with a higher primary patency rate.
Предметные рубрики MeSH
AdultAgedBudd-Chiari SyndromeComputed Tomography AngiographyConstriction, PathologicDevice RemovalEndovascular ProceduresFemaleHumansMaleMiddle AgedPhlebographyProsthesis DesignRetrospective StudiesStentsThrombolytic TherapyTime FactorsTreatment OutcomeUltrasonography, Doppler, ColorVascular PatencyVena Cava, Inferior