Budd-Chiari syndrome (BCS) results from hepatic venous outflow obstructionat any level from hepatic venules to the right atrium. Few patients respond tomedical treatment (anticoagulation ± thrombolytic therapy, diuretics). However, most patients need intervention to restore the hepatic blood flow. Restoring outflow in one of the major hepatic veins by balloon dilatation ± stenting is the management of choice. When not possible or failed, transjugular intrahepatic portosystemic shunt (TIPS) is used. Follow up of patients after radiological intervention is crucial in order to assess patient improvement, shunt patency and function and to manage any procedure related complications.
A research article published on February 21, 2011 in the World Journal of Gastroenterology addresses this question. In this study, the authors demonstrated that morbidity and mortality following angioplasty ± stenting and TIPS are low with satisfactory outcome. This study may represent a future strategy for good selection of procedure candidates, maintenance of shunt patency by strict adherence to anticoagulation and early management of shunt dysfunction which are all crucial in clinical, laboratory and radiological improvement of BCS patients.