Objective：To evaluate the clinical application  of transcatheter thrombolytic therapy combined with percutaneous transluminal angioplasty in the treatment of Budd-Chiari Syndrome complicated with inferior vena cava thrombosis or lower extremity venous thrombosis.
Methods：Stenosis and occlusion of supra-hepatic inferior vena cava (IVC) accompanied by inferior vena cava thrombosis, or accompanied by unilateral or bilateral lower extremity deep venous thrombosis, were detected by angiography in 29 patients.  All patients received transcatheter thrombolytic therapy through popliteal vein, and 25 of them received secondary balloon angioplasty and stent implantation.
Results：After treatment, the thrombosis resolved or was markedly alleviated with patency of the vein in 18 cases, of which, 6 cases were simply treated with balloon angioplasty and 12 cases were treated with balloon angioplasty and stent implantation. However, after thrombolytic therapy,widespread old thrombosis was found in 9 cases, of which 7 cases were apparently alleviated after endovascular treatment. In 2 cases with significant bleeding tendency, the treatment was suspended, so the obstruction area was still extensive, but without pulmonary embolism. During an average follow-up of 31 months (range from 2 to 72 months), 21 cases had apparent amelioration of clinical symptoms and signs, 2 cases relapsed after earlier apparent relief and 2 cases were not relieved. The overall effective rate was 84.0%.
Conclusions：Transcatheter thrombolytic therapy via popliteal vein for Budd- Chiari Syndrome complicated with thrombosis of inferior vena cava or the lower limbs veins is more effective than systemic thrombolytic administration, and the subsequent interventional therapy is minimally invasive and effective. So this method can be considered as routine treatment for such disorders.