# Budd-Chiari Syndrome Treated With IVC Stenting With Subsequent Right Hepatic Vein to IVC Retrograde Sharp Recanalization

## TL;DR

A 60-year-old woman with Budd-Chiari syndrome due to IVC and hepatic vein webs was treated with stenting and later recanalization, leading to full symptom resolution.

## Contribution

A novel treatment approach combining IVC stenting and retrograde recanalization for multifocal venous webbing in Budd-Chiari syndrome.

## Key findings

- IVC stenting initially resolved symptoms of Budd-Chiari syndrome caused by venous webbing.
- Delayed recurrence was successfully treated with right hepatic vein to IVC retrograde recanalization and stenting.
- The patient remained symptom-free for 2 years after the second intervention.

## Abstract

Venous webs of the inferior vena cava (IVC) and hepatic veins are rare and can result in Budd-Chiari syndrome. Included images of classic venous webbing are from a 60-year-old woman who presented with abdominal distension/pain, lower extremity edema, elevated liver tests, and ascites due to multifocal venous webbing of the IVC and right hepatic vein. The patient was successfully treated with IVC venous stent placement. Delayed recurrence of ascites, abdominal distention, and liver dysfunction after 3 years of follow-up was attributed to an additional right hepatic vein web/occlusion that was treated with a hepatic vein to IVC recanalization and stenting. The patient had complete resolution of symptoms at 2-year follow-up.