[Technical Frontiers] IVC Recanalization for Budd-Chiari Syndrome at Peking University People's Hospital

Clinical Challenge A 58-year-old female with 10-year chronic venous insufficiency was diagnosed with membrane-type Budd-Chiari Syndrome (BCS). Imaging showed IVC occlusion at the second hepatic hilum with decompensated cirrhosis. The proximity of the occlusion to the heart posed a high risk of pericardial tamponade or hemorrhage during recanalization.

Decision Logic The Peking expert team executed a sophisticated interventional strategy:

1. Precision Mapping: Simultaneous venography via both jugular and femoral access to define the membrane thickness and hemodynamic profile.
2. Recanalization: Under dual DSA and ultrasound guidance, the RUPS-100 set was used to puncture the occlusive membrane from the cephalad to the caudal end.
3. Stepwise Dilation: To prevent vascular rupture and manage sudden preload increase, serial balloon dilation (6mm to 14mm) was performed to ensure optimal luminal gain.

Patient Benefit Post-procedural venography confirmed full restoration of IVC flow directly into the atrium. Collateral vessels showed immediate regression. The patient experienced rapid relief from chronic symptoms, successfully halting the progression of hepatic and venous deterioration.