@article {Ding:2016:0954-691X:972,
title = "Outcome of the Z-expandable metallic stent for BuddChiari syndrome and segmental obstruction of the inferior vena cava",
journal = "European Journal of Gastroenterology & Hepatology",
parent_itemid = "infobike://wk/ejghe",
publishercode ="wk",
year = "2016",
volume = "28",
number = "8",
publication date ="2016-08-01T00:00:00",
pages = "972-979",
itemtype = "ARTICLE",
issn = "0954-691X",
eissn = "1473-5687",
url = "https://www.ingentaconnect.com/content/wk/ejghe/2016/00000028/00000008/art00019",
doi = "doi:10.1097/MEG.0000000000000640",
keyword = "balloon catheter, Budd–Chiari syndrome, stent, percutaneous transluminal balloon angioplasty, inferior vena cava",
author = "Ding, Peng-Xu and Li, Zhen and Zhang, Shui-Jun and Han, Xin-Wei and Wu, Yan and Wang, Zhong-Gao and Fu, Ming-Ti",
abstract = "
Objective
Treatment of segmental obstruction of the inferior vena cava (SOIVC) with Z-expandable metallic stents (Z-EMS) is controversial and data on long-term follow-up are lacking. We aimed to evaluate the long-term outcomes of the use of a Z-EMS for BuddChiari syndrome
(BCS) patients with SOIVC.
Materials and methods
Between August 2004 and December 2014, 37 consecutive BCS patients with SOIVC were referred for Z-EMS treatment and subsequently underwent follow-up in our department. Data were collected retrospectively and follow-up observations
were made 1, 2, 25, and 510 years postoperatively.
Results
Percutaneous transluminal balloon angioplasty and Z-EMS placement were technically successful in all patients. Major procedure-related complications occurred in four of 37 patients (10.81%). Follow-up
for 61.89\textpm41.45 months in 37 patients indicated portal hypertension in one patient 4 months after stent placement and symptoms were resolved by transjugular intrahepatic portosystemic stent shunting. Hepatocellular carcinoma was observed in four patients and five patients died during
follow-up. Reocclusion of the inferior vena cava occurred in four patients (10.81%, 4/41) and all reocclusions were managed by percutaneous transluminal balloon angioplasty. Cumulative 1-, 2-, 25-, and 510-year primary patency rates were 94.60% (35/37), 93.33% (28/30), 88.89%
(24/27), and 85.0% (17/20), respectively. Cumulative 1-, 2-, 25-, and 510-year secondary patency rates were 100% at all time-points.
Conclusion
These data suggest that Z-EMS implantation is an efficacious, safe, and curative approach for BCS with SOIVC because
satisfactory long-term outcomes were achieved. Long-term follow-up is required to ascertain stent patency and hepatocellular carcinoma occurrence.",
}