Objective: To investigate the causes for reintervention of Budd-Chiari syndrome (BCS) after endovascular treatment and the countermeasures.
Methods: The clinical data of 81 BCS patients undergoing two or more endovascular treatments from January 2013 to December 2016 were retrospectively analyzed. 
Results: Of the 81 patients, 3 cases (3.70%) were simple membranous obstruction of the inferior vena cava (lesion length ≤5 mm), 46 cases (56.79%) were short segmental obstruction of the inferior vena cava (lesion length >1~<5 cm), 17 cases (20.99%) were short segmental obstruction of the inferior vena cava (lesion length ≥5 cm), and 15 cases (18.52%) were obstruction of the inferior vena cava with complicating thrombosis of the inferior vena cava; 51 cases received two endovascular treatments, 21 cases had three, 8 cases had four and 1 case had eight endovascular treatments, respectively. In the entire group of patients, no death, pericardial tamponade, and no thoracic or abdominal hemorrhage caused by rupture of the inferior vena cava as well as pulmonary embolism occurred. All patients were discharged from the hospital uneventfully. Logistic regression analysis showed that the lesion length was an independent influential factor for repeated operation (P=0.000). Elastic retraction, no suitable stent for use and persistence of the etiological factor were the main reasons for repeated operation. 
Conclusion: In BCS patients with short segmental occlusion (>1 cm), long segmental occlusion or complicated by thrombosis of the inferior vena cava, repeated endovascular treatment is unavoidable. Regular follow-up and timely intervention are effective measures to prevent recurrence of symptoms.