Evaluation of outcome from endovascular therapy for Budd-Chiari syndrome: a systematic review and meta-analysis

Abstract

This study was performed to evaluate the outcome of endovascular intervention therapy for Budd-Chiari syndrome (BCS) and compare recanalization, transjugular intrahepatic portosystemic shunt (TIPS)/direct intrahepatic portosystemic shunt (DIPS), and combined procedure treatment. For the meta-analysis, 71 studies were identified by searching four databases. The individual studies’ samples were used to calculate a confidence interval (CI 95%), and data were pooled using a fixed-effect model and random effect model. The pooled measure and an equal-weighted average rate were calculated in all participant studies. Heterogeneity between the studies was assessed with I2, and T2 tests, and publication bias was estimated using Egger’s regression test. A total of 4,407 BCS patients had undergone an endovascular intervention procedure. The pooled results were 98.9% (95% CI 97.8‒98.9%) for a technical success operation, and 96.9% (95% CI 94.9‒98.9%) for a clinical success operation. The re-intervention rate after the initial intervention procedure was 18.9% (95% CI 14.7‒22.9%), and the survival rates at 1 and 5 years after the initial intervention procedure were 98.9% (95% CI 96.8‒98.9%) and 94.9% (95% CI 92.9‒96.9%), respectively. Patients receiving recanalization treatment (98%) had a better prognosis than those with a combined procedure (95.6%) and TIPS/DIPS treatment (94.5%). The systematic review and meta-analysis further solidify the role of endovascular intervention treatment in BCS as safe and effective. It maintains high technical and clinical success and long-term survival rates. The recanalization treatment had a better prognosis and outcome than the combined procedures and TIPS/DIPS treatment.

Budd-Chiari Syndrome Caused by Polycythemia Vera: A Case Report

“…Endovascular therapy is associated with high technical and clinical success rates. Other options include transjugular intrahepatic portosystemic shunt or, as a last resort, liver transplantation [ 15 ].…”

An Overview of Surgical Management of Portal Hypertension in Children

“…Budd–Chiari syndrome is usually managed with anticoagulation and interventional approaches such as angioplasty and transjugular intrahepatic portosystemic shunt (TIPS) placement. 10 Liver transplant is offered for patients in whom conservative management fails or liver disease progresses. 11 Chronic congestive heart failure can cause hepatic congestion and overtime can lead to liver fibrosis and cirrhosis.…”

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“…Uważa się, że ta błona mechanicznie ułatwia rozwój BCS. Chociaż struktura ta jest wrodzona, mechanizm jej rozwoju pozostaje niejasny [4,12].…”