Original Article
Copyright ©2011 Baishideng Publishing Group Co.
World J Gastroenterol. Feb 21, 2011; 17(7): 906-913
Published online Feb 21, 2011. doi: 10.3748/wjg.v17.i7.906
Table 1 Clinical manifestations and radiological criteria in studied patients
FindingsPatients, n (%)
Clinical manifestations
Abdominal pain23 (92)
Jaundice9 (36)
Lower limb edema10 (40)
Dilated veins over abdomen and trunk5 (20)
Tender hepatomegaly16 (64)
Ascites24 (96)
Radiological criteria
Hepatomegaly24 (96)
Splenomegaly22 (88)
Absent1 (4)
Present24 (96)
Liver mottling appearance17 (68)
Intra hepatic collaterals16 (64)
Caudate lobe hypertrophy12 (48)
Hepatic Veins:Short segment occlusion
RHV2 (8)
MHV7 (28)
LHV5 (20)
Total occlusion
RHV23 (92)
MHV18 (72)
LHV20 (80)
Table 2 Details of patients who needed revisions and their follow up (n = 10)
PatientInterventionTime of dysfunctionAction takenNo of revisions1 yr patencyEnd of FUP patency
23 yr FAngioplasty without stentingDay 7 and Day 10TIPS was done, occluded at day 10; then re-angioplasty was done12PatentPatent at 20th mo
27 yr MAngioplasty and stentingDay 7 and 2nd yrAngioplasty was done-then angioplasty + thrombectomy2PatentPatent at 24th mo
28 yr FAngioplasty and stenting4th moAngioplasty + local thrombolytic therapy1PatentPatent at 12th mo
30 yr FAngioplasty and stenting1st, 4th, 6th and 9th moTIPS was done-then angioplasty (3 times)4Occluded at 9th moOccluded at 24th mo
28 yr MAngioplasty and stenting3rd mo and 14th moAngioplasty + stent was done-then mesoatrial shunt1Occluded at 1 yrDead2 at 17th mo
27 yr FTIPSDay 1(stent occlusion and migration to portal vein) - Re (TIPS)1PatentPatent at 20th m
33 yr FTIPSDay 3Angioplasty + thrombectomy + systemic thrombolytic therapy1PatentPatent at 32nd mo
37 yr FTIPSDay 7 and 1st moAngioplasty (2 times)2PatentPatent at 12th mo
27 yr MTIPSDay 7, 3rd and 8th moAngioplasty (3 times)3PatentOccluded at 20th mo
17 yr MTIPS1st moPatient refused intervention0OccludedOccluded at 12th mo
Table 3 Patient survival n (%)
One year
Alive12 (100)13 (100)25 (100)
Dead0 (0)0 (0)0 (0)
End of follow up
Alive11 (91.6)13 (100)24 (96)
Dead1 (8.4)0 (0)1 (4)
Table 4 Clinical data of patients before and after intervention
Before intervention
One year after intervention
P valueSig
Patients with occluded shunts (n = 3)
Abdominal pain3021> 0.05NS
Jaundice1203> 0.05NS
Lower limb edema2112> 0.05NS
Dilated veins1203> 0.05NS
Ascites3030> 0.05NS
Patients with patent shunts (n = 22)
Abdominal pain202121< 0.001VHS
Jaundice814022< 0.01HS
Lower limb edema814121< 0.05S
Dilated veins418022> 0.05NS
Ascites211121< 0.001VHS
Table 5 Lab data and performance status of patients before and after intervention
Before intervention
One year after intervention
P valueSig
Patients with occluded shunts (n = 3)
ALT (N = 7-40 IU/L)70.3375.07029.6624.66> 0.05NS
AST (N = 7-37 IU/L)4224.24042.3332.51> 0.05NS
Total bilirubin (N = 0.2-1.2 mg/dL)2.92.9401.260.832> 0.05NS
Direct bilirubin (N = 0-0.3 mg/dL)1.531.5600.530.577> 0.05NS
Albumin (N = 3.5-5.3 g/dL)3.70.8003.560.901> 0.05NS
Performance status3.330.5772.001.730> 0.05NS
Patients with patent shunts (n = 22)
ALT (N = 7-40 IU/L)66.95117.26526.458.528< 0.05S
AST (N = 7-37 IU/L)53.9533.83232.229.586< 0.01HS
Total bilirubin (N = 0.2-1.2 mg/dL)2.8183.1981.210.414< 0.01HS
Direct bilirubin (N = 0-0.3 mg/dL)1.292.0220.510.296< 0.01HS
Albumin (N = 3.5-5.3 g/dL)3.50.4753.930.576< 0.01HS
Performance status2.591.0070.180.664< 0.001VHS
Table 6 Comparison of different transjugular intrahepatic portosystemic shunt studies in Budd-Chiari syndrome with the current study
Points of comparisonMancuso et al[18]Perelló et al[19]Rössle et al[20]Hernández-Guerra et al[21]Current study
No. of patients15133525 (9 covered stents)13
Mean age in years (range)40 (20-73)36 (17-67)43 (12-74)40 (17-54)29 (14-57)
Median child score119998
Acute, fulminant/chronic presentation8/64/611/13ND2/11
Mean follow-up (mo)2448372018
Stent stenosis (%)36724767 (19% covered stents)38.4
Anticoagulation (%)10095100ND100
Patients with acute presentation who died4ND2ND0
Patients with chronic presentation who died0ND1ND0
Death total (%)3010900
Liver transplantation01200
Surgical portocaval shunt02000