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This study was designed to assess the clinical efficiency and long-term outcomes of hepatic vein (HV) and accessory hepatic vein (AHV) recanalization in patients with HV-type Budd-Chiari syndrome (BCS). A total of 27 patients with HV-type BCS underwent AHV recanalization and 94 patients had HV recanalization at our center from January 2012 to December 2019. The treatment effectiveness and long-term outcomes were compared. Technical success was accomplished in all patients, without any procedure-related complications. The clinical success rates were 96.3% (26/27) and 95.7% (90/94) ( p  = 1.000). In the AHV and HV groups, re-obstruction was observed in 5 and 36 patients, respectively ( p  = 0.056). The median primary durations of AHV and HV patency were 64 and 49 months, respectively ( p  = 0.036), while the median secondary durations of AHV and HV patency were 70 and 64 months, respectively ( p  = 0.134). The median overall survival after AHV and HV recanalization was 73 and 78 months, respectively ( p  = 0.263). Our findings suggest that AHV could be employed as a replacement for HV, as a hepatic drainage vein, in HV-type BCS patients.

Percutaneous recanalization in hepatic vein-type Budd-Chiari syndrome: hepatic or accessory hepatic vein