Reversion of liver cirrhosis after endovascular treatment in Chinese patients with Budd‐Chiari syndrome

Aims

To investigate the impact of endovascular (EV) treatment on liver cirrhosis in Chinese patients with Budd‐Chiari syndrome (BCS).

Methods

From September 2011 to March 2022, 97 patients from four hospitals in China who were diagnosed with primary BCS complicated with liver cirrhosis and received EV treatment were retrospectively enrolled in this study for clinical analysis. In addition, liver tissues for basic research were acquired from 25 patients between June 2022 and March 2023, including 6 with benign liver tumors, 11 with BCS before EV treatment, and 8 with EV‐treated BCS. Liver cirrhosis was assessed by clinical outcomes, histological studies, and the expression of related genes at the mRNA and protein levels.

Results

The patients with BCS had better liver function after EV treatment, evidenced by an increased albumin level and reduced total bilirubin, ALT, and AST. The imaging findings suggested an amelioration of liver cirrhosis and portal hypertension, including increased portal vein velocity (13.52±8.89cm/s vs 17.51±6.67cm/s, p<0.001) and decreased liver stiffness (30.37±6.39kPa vs 23.70±7.99kPa, p<0.001), portal vein diameter (14.97±3.42mm vs 13.36±2.89mm, p<0.001), and spleen volume (870.00±355.61cm³ vs 771.36±277.45cm³, p<0.001). Furthermore, histological studies revealed that EV treatment resulted in a restoration of liver architecture with reduced extracellular matrix deposition. Meanwhile, hepatic angiogenesis and inflammation, which have a close relationship with cirrhosis, were also inhibited. And the state of hepatocytes switches from apoptosis to proliferation after EV treatment.

Conclusions

BCS‐induced liver cirrhosis could be reversed by EV treatment from macroscopic to microcosmic dimensions. Our study may provide further insights into understanding BCS and treating cirrhosis.

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