Endovascular Management of Budd Chiari Syndrome: Techniques and proposed treatment algorithm

Congress:

ECR 2022

Poster Number:

C-19962

Type:

Educational Exhibit

Keywords:

Abdomen, Catheter venography, Angioplasty, Arterial access, Stents, Cirrhosis, Embolism / Thrombosis

Authors:

A. Israr, R. R. Yadav, S. Singh, K. B. K. Rangan, R. V. Mall

DOI:

10.26044/ecr2022/C-19962

DOI-Link:

https://dx.doi.org/10.26044/ecr2022/C-19962

Learning objectives

Budd Chiari syndrome (BCS) is a clinical condition resulting from impaired hepatic venous drainage, due to obstruction of hepatic venous outflow at any level extending from the small hepatic veins to the junction of the inferior vena cava and the right atrium leading to hepatic congestion. Untreated cases have high mortality rates: up to 90% at 3 years post presentation [1].

We aim to highlight the various endovascular techniques at the disposal of the interventional radiologists for the treatment of this disease with pictorial examples and a brief review of recent literature.

Fig 1: Types Budd Chiari Syndrome of with various aetiologies.

Fig 2: Clinical presentation and Pathogenesis of Budd Chiari Syndrome

Fig 3: USG findings of BCS and different types of stenosis References: Department of...

Fig 4: CT angiogram Axial images; (A) Non contrast image showing nodular outline of...

Fig 5: Various Treatment options in Budd Chiari Syndrome

Fig 6: Patient Selection for various endovascular procedures

Fig 7: Algorithm for management of Budd Chiari Syndrome

Fig 8: Transjugular/Trans femoral HV/IVC Recanalization References: Department of...

Fig 9: Transjugular HV Recanalization, not responding to angioplasty and hence...

Fig 10: Percutaneous HV/IVC Recanalization : when endovascular recanalization is...

Fig 11: Shunt Procedure (TIPSS/DIPPS) References: Department of Radiodiagnosis,...

Fig 12: Complications seen in various Interventional procedures

Fig 13: Contraindications to TIPSS/DIPSS

Fig 14: Budd Chiari Syndrome-- Prognostic Scores for predicting mortality

Fig 15: Post procedure care and follow up protocol