Abstract:

Objective To comparatively analyze the clinical efficacies of treatment to Budd-Chiari syndrome with inferior vena cava thrombosis. Methods Retrospective analysis of clinical data of 68 cases of membranous or short-segment occlusion Budd-Chiari syndrome with inferior vena cava thrombosis was performed. Depending on the treatment methods of inferior vena cava thrombosis, patients were randomly divided into three groups, i.e. predilation technique group (group A with 21 cases), catheter directed thrombolysis group (group B with 20 cases), and conservative treatment group (group C with 27cases). Digital subtraction angiography (DSA) observations of the inferior vena cava thrombolysis were conducted every 48 h. After thrombi were completely dissolved, conventional large balloons of 20-30 mm were used to inflate the lumen stenoses or occlusion segments. Results Two days after treatment, the thrombolytic rate of group A (76.2%) was significantly higher than that of group B (45.0%) and group C (18.5%)(P＜0.05), and the thrombolytic rate of group B was significantly higher than that of group C (P＜0.05). Four days after treatments, the difference of the thrombolytic rates of group A (85.7%) and group B (75.0%) was not statistically significant (P＞0.05), and the thrombolytic rates of group A and group B were significantly higher than that of group C (37.0%)(P＜0.05). Six days after treatments, the difference of the thrombolytic rates of group A (90.5%) and group B (90.0%) was not statistically significant (P＞0.05), and the thrombolytic rates of group A and group B were significantly higher than that of group C (51.9%)(P＜0.05). After six days, all patients with anticoagulant and thrombolytic therapy had no sign of symptomatic pulmonary embolism, bleeding, and other serious complications. Conclusion The clinical efficacies of predilation technique and catheter directed thrombolysis are all good for the treatment of Budd-Chiari syndrome with inferior vena cava thrombosis and the former is safer and quicker.

Key words: Budd-Chiari syndrome, inferior vena cava, thrombosis, interventional treatment