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IR Management of Budd–Chiari Syndrome

  • Amar Mukund
  • Basavaraj Biradar
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  • 37 Downloads

Abstract

Budd–Chiari syndrome (BCS) is characterized by obstruction of hepatic venous outflow in the absence of cardiac pathology. BCS is categorized as primary or secondary based on the etiology of obstruction of hepatic veins. It may be asymptomatic or may present as fulminant/acute/subacute and chronic forms. Subacute/chronic forms are seen commonly in Asia. Acute thrombosis of hepatic vein (HV) and/or intrahepatic inferior vena cava (IVC) presents as acute BCS, whereas ostial stenosis/membranous/short segment obstruction/thrombosis of HV/suprahepatic IVC presents as subacute/chronic BCS. All forms of disease lead to reduced hepatic perfusion pressure and eventually rise in portal pressure leading to portal hypertension. Therapeutic stepwise approach to BCS begins from anticoagulation, diuretics, medical management of portal hypertension, angioplasty with or without stenting for venous stenosis, creation of portosystemic shunts, and ultimately liver transplantation. Endovascular treatment has been very effective in relieving hepatic congestion and symptoms of portal hypertension. These treatments are aimed at restoring the venous outflow or creating a portosystemic shunt leading to the improvement in the liver functions and providing long-term transplant-free survival period.

Keywords

Budd–Chiari syndrome (BCS) HVOTO TIPS DIPS 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2021

Authors and Affiliations

  • Amar Mukund
    • 1
  • Basavaraj Biradar
    • 2
  1. 1.Interventional RadiologyInstitute of Liver and Biliary SciencesNew DelhiIndia
  2. 2.Manipal HospitalBengaluruIndia

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