To Compare "Balloon Occluded Thrombolysis" With "Conventional Catheter Directed Thrombolysis" in Thrombotically Occluded DIPSS Stent in Patients of Budd- Chiari Syndrome.
Condition: Budd-Chiari Syndrome
MeSH terms: Budd-Chiari Syndrome; Syndrome
Study type: Observational

Summary: 
      DIPSS has become a widely accepted treatment for complications of portal hypertension. Shunt
      or hepatic vein stenosis are common short and mid term complications of the procedure. When
      identified early, shunt stenosis or occlusion may be treated before recurrence of the
      symptoms for which DIPSS was done at the first place. Present day endovascular DIPSS revision
      techniques have significantly improved the primary assisted patency rates.

      The purpose of this study is to understand the newer technique of Combined balloon occlusion
      thrombolysis and intra stent balloon sweeping being practiced at our institute and compare it
      with the widely used conventional thrombolytic methods.
    

Detailed description: 
      Primary objective:

        1. To study the outcome of combined technique of Balloon occluded thrombolysis, Balloon
           sweeping and maceration of thrombus in Blocked DIPSS stent and compare it with
           Conventional catheter directed thrombolysis and angioplasty.

           Secondary objective:

        2. Study DIPSS stent patency and re-occlusion rates at 1 month followup

      Methodology:

      Study population: Patients with Budd -Chiari syndrome who underwent DIPSS revision till
      February 2021

      Study design: Single center retrospective cohort study

      Study period: 1year

      Sample size: All eligible patients according to inclusion and exclusion criteria who
      underwent TIPS/DIPS revision will be included in thestudy.

      Intervention: DIPSS Revision

      Monitoring andassessment:

      The following parameters to be evaluated over a period at least 1 month after DIPSS revision
      and compare with pre revisionvalues

      Clinical parameters:

      Status of ascites Urine output Recurrence of UGI/LGI bleed

      Laboratory parameters:

      ALBI Score,LFT, KFT

      DOPPLER PARAMETERS:

      Mid stent velocity, velocity at hepatic venous end Main portal vein velocity Direction of
      flow in intrahepatic portal vein branches

      Stopping rule: Not applicable.

      Expected outcome of the project: Balloon Occluded thrombolytic infusion alongwith intratsent
      balloon sweeping gives faster and better patency as compared to conventional
      pharmaco-mechanicalthrombolytic methods
    

Intervention name(s): Novel; Conventional
Intervention type(s): Procedure; Procedure
Intervention description(s): Balloon- Occlusion thrombolysis was done in adjunct to thrombus maceration, balloon sweeping and thrombosuction.; Continuous catheter directed thrombolysis (Continuous urokinase infusion) was done along with thrombus maceration, balloon sweeping and thrombosuction.
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Patients with Budd -Chiari syndrome who underwent DIPSS revision till February 2021