• Qianxin Huang, Bin Shen, Qingqiao Zhang, Hao Xu, Maoheng Zu, Yuming Gu, Ning Wei, Yanfeng Cui, and Rui Huang.
• From the Department of Interventional Radiology, the Affiliated Hospital of Xuzhou Medical College, Xuzhou, China.
• Circ Cardiovasc Interv. 2016 Mar 1; 9 (3): e003104.

BackgroundEndovascular management is important for the treatment of primary Budd-Chiari syndrome, which is caused by inferior vena cava (IVC) obstruction. The aims of this study were to compare long-term outcomes of endovascular management for primary Budd-Chiari syndrome patients with membranous obstruction of IVC (MOVC) and segmental obstruction of IVC (SOVC) and explore the optimal endovascular strategy for these conditions.Methods And ResultsClinical data of 265 patients with Budd-Chiari syndrome who received endovascular management (MOVC group, n=136; SOVC group, n = 129) were retrospectively reviewed. Cumulative IVC patency rates were generated by the Kaplan-Meier method and compared by log-rank test. In total, 245 patients were followed up from 3 to 72 months after treatment. The difference of long-term outcomes of balloon dilation alone versus stent placement was not significant in each group. The overall cumulative 1-, 3-, and 5-year primary IVC patency rates were 98.3%, 90.7%, and 83.8% in the MOVC group and 88.3%, 79.1%, and 67.9% in the SOVC group (P=0.007), respectively. The long-term IVC patency rates were lower in the SOVC group than in the MOVC group for patients who underwent balloon dilation alone (P=0.001) and did not significantly differ for patients who underwent stent placement between both the groups (P=0.687).ConclusionsThe long-term treatment outcome of endovascular management was better for primary Budd-Chiari syndrome patients with MOVC than for those with SOVC. Balloon dilation alone could be the optimal treatment for patients with MOVC. However, stent placement should be more strongly recommended for patients with SOVC.© 2016 American Heart Association, Inc.

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