Outcomes of thrombolysis with and without predilation of the inferior vena cava (IVC) in patients with Budd-Chiari syndrome with old IVC thrombosis.

PURPOSE: To compare the efficacy of thrombolysis with and without predilation of the inferior vena cava (IVC) for Budd-Chiari syndrome (BCS) with old IVC thrombosis.

METHODS

We divided 40 patients with BCS with old IVC thrombosis into 2 groups, group A (n = 21), thrombolysis after dilation of the obstructed IVC and group B (n = 19), thrombolysis without predilation of the obstructed IVC. Thrombolysis was performed via urokinase administration through the dorsal vein of the foot.

RESULTS

Color Doppler ultrasonography at 30 days showed complete resolution of the thrombus in 21 (100%) group A patients and 6 group B patients (31.6%; P < .001). Thrombolysis was achieved using a lower dose of urokinase and within a shorter time frame in group A than in group B (P < .001).

CONCLUSIONS

Thrombolysis after dilation was superior to thrombolysis alone and was safe and efficacious in patients with BCS with old IVC thrombosis.