How should I treat Budd-Chiari syndrome after liver transplantation with inferior vena cava occlusion?

Saima Karim, Victor Lucas, Anil Verma, Nigel Girgrah, Stephen Ramee, Fausto Castriota, Antonio Micari, Giuseppe Roscitano, Francesco Spinelli, Sameer Gafoor, Abdul Haseeb, Asad Khan, Jennifer Franke, Predrag Matic, Markus Reinartz, Stefan C Bertog, Laura Vaskelyte, Ilona Hofmann, Horst Sievert

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: A 64-year-old male with Budd-Chiari syndrome (BCS) due to inferior vena cava (IVC) occlusion after liver transplant presented with massive ascites and lower extremity oedema. INVESTIGATION: A computed tomography venogram (CTV) of the abdomen and pelvis was performed after workup including venous ultrasound could not identify the aetiology of the oedema. DIAGNOSIS: The patient was found to have chronic total occlusion (CTO) of the suprahepatic IVC with thrombosis in the hepatic, renal, and iliac veins and the infrahepatic IVC. MANAGEMENT: Venography of the IVC along with catheter directed thrombolysis were performed on the first day. Subsequently, a transseptal needle was used to transverse the occlusion. A snare was used from the IVC to retract a guidewire cranially through the tract. The lesion in the IVC was then dilated and stented with the help of IVUS.

Original languageEnglish (US)
Pages (from-to)124-128 and 1-3
JournalEuroIntervention
Volume12
Issue number1
DOIs
StatePublished - May 2016

Keywords

  • Budd-Chiari syndrome
  • Inferior vena cava occlusion
  • Inferior vena cava stent placement
  • Liver transplant
  • Pedal oedema

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