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Clinical outcomes of warfarin anticoagulation following balloon dilation alone for the treatment of Budd-Chiari Syndrome complicated by old inferior vena cava thrombosis.
MedLine Citation:
PMID:  25014178     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: To evaluate the safety and clinical efficacy of warfarin anticoagulation following balloon dilation alone for the treatment of Budd-Chiari syndrome (BCS) complicated by old inferior vena cava (IVC) thrombosis.
METHODS: From January 2008 to November 2013, 19 BCS patients complicated with old IVC thrombosis were treated with balloon dilation followed by oral administration of anticoagulant warfarin. Follow-up was performed at 1 week and 1, 2, 3, 6 and 12 months after balloon dilation and then annually thereafter. IVC patency and morphological changes of the old thrombus were examined by ultrasound, and clinical symptoms and signs were determined by clinical examinations during follow-up.
RESULTS: Successful IVC balloon dilation was achieved in the 19 patients (100%). Inferior vena cavography demonstrated the patency of IVC lumen and the size of the old thrombus was not altered. The mean pressure gradient between IVC and the right atrium was reduced from (27.5±3.0) (range: 22-35) cmH2O before treatment to (5.4±1.3) (range: 2-7) cmH2O after treatment (t=41.6, P <0.05) (1cmH2O=0.098kPa). Patients were followed up as outpatients for an average of (15.9 ±14.4) (range: 3-66) months. Anticoagulation with warfarin was well tolerated in all patients following balloon dilation alone. Of the 19 patients, complete resolution of the old thrombus was achieved in 12 patients and partial resolution was achieved in 7 patients. Color Doppler ultrasound showed that 17 patients had IVC lumen patency, and 2 patients had IVC re-occlusion. None of the patients had recurrence of thrombosis, symptomatic pulmonary embolism and bleeding complications throughout the follow-up period.
CONCLUSIONS: Our results indicate that warfarin anticoagulation following balloon dilation alone is a safe and effective therapy for BCS patients with old IVC thrombosis.
Authors:
Jingmin Sun; Qingqiao Zhang; Hao Xu; Qianxin Huang; Bin Shen; Maoheng Zu; Yuming Gu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-8
Journal Detail:
Title:  Annals of vascular surgery     Volume:  -     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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