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Strozzi M, Besic KM, Ivana KS, et al. Endovascular treatment of an obstructive membrane between inferior vena cava and right atrium in an unrecognized Budd-Chiari syndrome. CVIR Endovasc. 2020;3(1):76doi: 10.1186/s42155-020-00168-5.
Strozzi, M., Besic, K. M., Ivana, K. S., & Darko, A. (2020). Endovascular treatment of an obstructive membrane between inferior vena cava and right atrium in an unrecognized Budd-Chiari syndrome. CVIR endovascular, 3(1), 76. https://doi.org/10.1186/s42155-020-00168-5
Strozzi, Maja, et al. "Endovascular treatment of an obstructive membrane between inferior vena cava and right atrium in an unrecognized Budd-Chiari syndrome." CVIR endovascular vol. 3,1 (2020): 76. doi: https://doi.org/10.1186/s42155-020-00168-5
Strozzi M, Besic KM, Ivana KS, Darko A. Endovascular treatment of an obstructive membrane between inferior vena cava and right atrium in an unrecognized Budd-Chiari syndrome. CVIR Endovasc. 2020 Oct 13;3(1):76. doi: 10.1186/s42155-020-00168-5. PMID: 33048283; PMCID: PMC7554274.
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CVIR Endovasc. 2020 Oct 13;3(1):76. doi: 10.1186/s42155-020-00168-5.

Endovascular treatment of an obstructive membrane between inferior vena cava and right atrium in an unrecognized Budd-Chiari syndrome.

CVIR endovascular

Maja Strozzi, Kristina Maric Besic, Knezevic Stromar Ivana, Anić Darko

Affiliations

  1. University Clinic for Cardiovascular Diseases, Clinical Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia. [email protected].
  2. Department for Adult Congenital Heart Disease, University Clinic for Cardiovascular Diseases, Clinical Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia. [email protected].
  3. University Clinic for Cardiovascular Diseases, Clinical Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
  4. Department of Gastroenterology, University Clinic for Internal Medicine, University Hospital Center, University of Zagreb School of Medicine, Zagreb, Croatia.
  5. University Clinic for Heart Surgery, Clinical Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.

PMID: 33048283 PMCID: PMC7554274 DOI: 10.1186/s42155-020-00168-5

Abstract

BACKGROUND: Budd-Chiari syndrome is defined as a hepatic venous outflow track obstruction of various etiology, which appears at different levels. The inferior vena cava outflow membrane is an unusual, but a potentially treatable cause. The percutaneous treatment has emerged as a very promising management mode for such patients. Follow-up results are favorable for balloon angioplasty and/or stenting, with minimal re-stenosis rates.

CASE PRESENTATION: We report a case of a young woman, earlier operated on congenital heart defect and with previous pulmonary embolic incident after childbirth, with no evidence of thrombophilia. She was admitted to our institution for a suspected right atrial tumor. After the diagnosis of Budd-Chiari syndrome caused by membranous inferior vena cava obstruction, a percutaneous treatment of a thick membrane was successfully performed, using an unusual technique.

CONCLUSION: Balloon angioplasty should be considered in cases of membranous obstruction of vena cava, where a focal obstruction is causing the symptoms. In our patient, the anatomy was not suitable for stenting, and balloon dilatation was successful just after the membrane was pulled apart with a big balloon in a "Rashkind-like" procedure.

Keywords: Balloon angioplasty; Budd-Chiari syndrome; Inferior vena cava membrane; Intravenous percutaneous intervention

References

  1. Darwish Murad S, Plessier A, Hernandez-Guerra M, Fabris F, Eapen CE, Bahr MJ et al (2009) Etiology, management, and outcome of the Budd-Chiari syndrome. Ann Intern Med 151(3):167–175 - PubMed
  2. Han G, Qi X, Zhang W, He C, Yin Z, Wang J et al (2013) Percutaneous recanalization for Budd-Chiari syndrome: an 11-year retrospective study on patency and survival in 177 Chinese patients from a single center. Radiol 266(2):657–667 - PubMed
  3. Janssen HL, Garcia-Pagan JC, Elias E, Mentha G, Hadengue A, Valla DC (2003) Budd-Chiari syndrome: a review by an expert panel. J Hepatol 38:364–371 - PubMed
  4. Janssen HL, Meinardi JR, Vleggaar FP, van Uum SH, Haagsma EB, van Der Meer FJ et al (2000) Leiden mutation, prothrombin gene mutation, and deficiencies in coagulation inhibitors associated with Budd-Chiari syndrome and portal vein thrombosis: results of a case-control study. Blood 96(7):2364–2368 - PubMed
  5. Kucukay F, Akdogan M, Bostanci EB, Ulus AT, Kucukay MB (2016) Percutaneous Transluminal angioplasty for complete membranous obstruction of Suprahepatic inferior vena cava: long-term results. Cardiovasc Intervent Radiol Oct 39(10):1392–1399. https://doi.org/10.1007/s00270-016-1394-2 - PubMed
  6. Okuda K (2001) Membranous obstruction of the inferior vena cava (obliterative hepatocavopathy, Okuda). J Gastroenterol Hepatol Nov 16(11):1179–1183 - PubMed
  7. Plessier A, Valla DC (2008) Budd-Chiari syndrome. Semin Liver Dis 28(3):259–269 - PubMed
  8. Poddar P, Gurizala S, Rao S (2014) Endovascular stenting of IVC using Brockenborough's needle in Budd-Chiari syndrome - a case report. Indian Heart J May-Jun 66(3):363–365. https://doi.org/10.1016/j.ihj.2014.03.014 Epub 2014 Apr 16 - PubMed
  9. Sevenet F, Deramond H, Hadengue A, Casadevall N, Delamarre J, Capron JP (1989) Membranous obstruction of the inferior vena cava associated with a myeloproliferative disorder: a clue to membrane formation? Gastroenterol 97(4):1019–1021 - PubMed
  10. Srinivas BC, Dattatreya PV, Srinivasa KH, Prabhavathi MCN (2012) Inferior vena cava obstruction: long-term results of endovascular management. Indian Heart J Mar-Apr 64(2):162–169. https://doi.org/10.1016/S0019-4832(12)60054-6 Epub 2012 Apr 28 - PubMed
  11. Xu PQ, Ma XX, Ye XX, Feng LS, Dang XW, Zhao YF et al (2004) Surgical treatment of 1360 cases of Budd-Chiari syndrome: 20-year experience. Hepatobiliary Pancreat Dis Int Aug 3(3):391–394 - PubMed
  12. Yang XL, Cheng TO, Chen CR (1996) Successful treatment by percutaneous balloon angioplasty of Budd-Chiari syndrome caused by membranous obstruction of inferior vena cava: 8-year follow-up study. J Am Coll Cardiol 28:1720–1724 - PubMed

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