Comparative study of predilation with stent filter for Budd-Chiari syndrome with old IVC thrombosis: A nonrandomized prospective trial

PurposeTo evaluate whether predilation approach yield intermediate-term results were better than those with stent filter approach.Materials and methods59 BCS patients with old IVC thrombosis were selected for the treatment with a stent filter (n = 33, group A) or predilation (n = 26, group B) before thrombolysis, and subsequently underwent color Doppler ultrasound follow-up at our hospital. Data relating to the technical success, color Doppler ultrasound results, cost, mortality, morbidity, and final clinical results were collected prospectively and follow-ups were performed 1, 3, 6, and 12 months after the procedures, and annually thereafter.ResultsSent filter placement, thrombolysis and predilation were technically successful in all patients, with no procedure-related complications. Stent migration upward occurred in two patients, and removal of the stent filter was technically successful in 32 of 33 patients in group A. Inferior vena cavagrams performed before dilation with a 30-mm balloon catheter demonstrated that the IVC thrombus had completely resolved in all patients without pulmonary embolism. Reobstruction of the IVC without thrombosis was observed in three patients. Short of higher overall complications and costs in group A when compared to group B, there were no other differences in the clinical and color Doppler ultrasound findings, and primary patency rate between the two groups. All patients are alive with no recurrence of thrombosis at the time of this report.ConclusionsBCS patients with old IVC thrombosis treatment with predilation approach yielded intermediate-term results that were better than those with the stent filter approach.