To identify the influencing factors of pathological progression in patients with Budd-Chiari syndrome (BCS) after endovascular treatment.

Clinical data of 55 patients with BCS admitted the First Affiliated Hospital of Bengbu Medical College from January 2014 to December 2020 were retrospectively analyzed. Among them, 24 patients were male and 31 female, aged (48±11) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. After the first endovascular treatment, 31 patients were diagnosed with simple diaphragm type BCS, 18 cases with short-segment lesion type BCS and 6 cases with long-segment lesion type BCS. All enrolled patients received multiple endovascular treatments for consecutive 3 years or longer. The pathological progression of lesion was observed. The effects on the changes of lesions by age upon first admission, sex, frequency of surgeries, average patency time, type of lesion upon first admission and duration of taking anticoagulants were evaluated by multivariate Logistic regression analysis.

55 patients received 288 times of endovascular treatment which was balloon dilatation. The success rate of surgery was 100%. The vascular recanalization rate was 100%. The median time of the first patency was 9 months, 8 months for the second patency, 8 months for the third patency and 8 months for the last patency. During the treating period, the lesion type changed in 22 patients. Among them, simple diaphragm type progressed to short-segment lesion type in 13 cases, short-segment lesion type evolved to long-segment lesion type in 5, short-segment lesion type complicated with thrombosis in 3, and long-segment lesion type progressed to mixed lesion type in 1. Multivariate Logistic regression analysis demonstrated that the time of use of anticoagulants was an independent factor affecting the progression of BCS (OR=0.124, 95%CI: 0.032-0.479, P=0.002).

Patients with BCS have the tendency of progression after endovascular treatment. Thrombosis is a critical factor for disease progression. Regular use of anticoagulants might retard the progression of lesions.