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首页> 外文期刊>Annals of vascular surgery >Clinical outcomes of warfarin anticoagulation after balloon dilation alone for the treatment of budd-chiari syndrome complicated by old inferior vena cava thrombosis
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Clinical outcomes of warfarin anticoagulation after balloon dilation alone for the treatment of budd-chiari syndrome complicated by old inferior vena cava thrombosis

机译：单用球囊扩张术后华法林抗凝治疗伴发性下腔静脉血栓形成的巴德加里综合征的临床结果

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Background To evaluate the safety and clinical efficacy of warfarin anticoagulation after 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, then 1, 2, 3, 6, and 12 months after balloon dilation, and then annually thereafter. IVC patency and morphologic 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 cm H2O (range, 22-35) before treatment to 5.4 ± 1.3 cm H2O (range: 2-7) after treatment (t = 41.6, P 0.05; 1 cm H2O = 0.098 kPa). Patients were followed up as outpatients for an average of 15.9 ± 14.4 months (range, 3-66). Anticoagulation with warfarin was well tolerated in all patients after 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 reocclusion. 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 after balloon dilation alone is a safe and effective therapy for BCS patients with old IVC thrombosis.
机译：背景：目的评价华法林单独行球囊扩张术后抗凝治疗布加综合征（BCS）并发下腔静脉血栓（IVC）的安全性和临床疗效。方法从2008年1月至2013年11月，本研究共计19例BCS并发患者较旧的IVC血栓形成应通过球囊扩张术治疗，然后口服抗凝华法林。随访在球囊扩张后的1周，1、2、3、6和12个月进行，然后每年进行一次。超声检查IVC的通畅性和旧血栓的形态学变化，并在随访过程中通过临床检查确定临床症状和体征。结果19例患者（100％）成功完成了IVC球囊扩张术。下腔静脉造影显示IVC管腔通畅，旧血栓的大小未改变。 IVC和右心房之间的平均压力梯度从治疗前的27.5±3.0 cm H2O（范围22-35）降低至治疗后的5.4±1.3 cm H2O（范围2-7）（t = 41.6，P <0.05 ; 1 cm H2O = 0.098 kPa）。对患者的门诊随访时间平均为15.9±14.4个月（范围3-66）。单独进行球囊扩张后，所有患者对华法林的抗凝耐受性均良好。在19例患者中，有12例患者完全消除了旧血栓，有7例患者获得了部分消除。彩色多普勒超声显示17例患者有IVC管腔通畅，2例患者有IVC闭塞。在整个随访期间，所有患者均未出现血栓形成，症状性肺栓塞和出血并发症的复发。结论我们的结果表明，单纯球囊扩张后的华法林抗凝治疗对于BCS伴有旧IVC血栓形成的患者是一种安全有效的疗法。

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