Among patients with hepatic venous outflow block, short-length hepatic vein stenosis was associated with significantly better 5-year survival compared to those without (80% vs. 50%, P<.05).
Cohort (n=86)
What are the prevalence, causes, manifestations, and outcomes of short-length hepatic vein stenoses in patients with hepatic venous outflow block?
Short-length hepatic vein stenosis is a common cause of hepatic venous outflow block associated with localized thrombosis and a better 5-year survival compared to other causes.
Absolute Event Rate: 80% vs 50%
p-value: p=<.05
In contrast with the well-recognized membranous obstruction of the inferior vena cava, short-length hepatic vein stenoses are not well-recognized causes of hepatic venous outflow block. The aim of this study was to ascertain the prevalence, causes, manifestations, and outcome of short-length hepatic vein stenoses. We performed a retrospective study of patients with short-length hepatic vein stenosis among 86 patients with hepatic venous outflow block who were seen between 1970 and 1992. There were 25 patients with short-length hepatic vein stenosis. A thrombogenic condition was identified in 14 patients (56%). The lesions of the accompanying hepatic veins in these patients were variable (short-length stenoses, thromboses, or nonspecific changes) and similar to that seen in patients without short-length hepatic vein stenosis. In 3 necropsied cases, the venous lesions were suggestive of fibrous sequela of prior thromboses. In patients with short-length hepatic vein stenosis, splenomegaly (28% vs. 55%, P < .05) and hypersplenism were significantly less common; serum transaminase (P < .001) and creatinine levels (P < .02) were lower, prothrombin was higher (P < .001), and 5-year survival was significantly better (Kaplan-Meier estimates: 80% vs. 50%, P < .05). In patients with hepatic venous outflow block, short-length hepatic vein stenosis is a common lesion that appears to be the sequela of localized thrombosis. Long-term anticoagulation and percutaneous angioplasty (with or without stenting) are potentially applicable in these lesions. The long-term results of these treatments merit further evaluation.
Valla et al. (Tue,) conducted a cohort in Hepatic venous outflow block (n=86). Short-length hepatic vein stenosis vs. Without short-length hepatic vein stenosis was evaluated on 5-year survival (p=<.05). Among patients with hepatic venous outflow block, short-length hepatic vein stenosis was associated with significantly better 5-year survival compared to those without (80% vs. 50%, P<.05).