Role of Inferior Vena Cava (IVC) Recanalization in Patients with Back Pain, Secondary to IVC Obstruction in Budd–Chiari Syndrome

Vijay Kubihal, Amar Mukund*, Yasha Pandey, Chitranshu Vashistha, Rakhi Maiwall, Yashwant Patidar, Anil Yogendra Yadav, Roshan Lal Koul, Shiv Kumar Sarin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


PURPOSE: To study the prevalence of back pain in patients of Budd-Chiari syndrome (BCS) with inferior vena cava (IVC) obstruction, and to evaluate the role of IVC recanalization in resolution of back pain.

METHODS: All patients with BCS and IVC obstruction who underwent IVC recanalization between January 2018 and October 2022 were included. Patients with degenerative spine disease or other identifiable causes for back pain were excluded; remaining patients were assessed for the presence of back pain. In patients with back pain, pain relief was assessed at 24 h following IVC recanalization.

RESULTS: Fifty-eight patients with BCS and IVC occlusion were identified, of which six with degenerative spine diseases were excluded. Of the remaining 52 patients, 34 (65.4%) had back pain, with pain score between 3 and 9. Engorged epidural venous plexus on preprocedural imaging ( p = 0.002), and degree of luminal narrowing ( p = 0.021) had a significant association with back pain. Twenty-nine of thirty-four patients (85.3%) with back pain had pain relief immediately following IVC recanalization, more so in patients with engorged epidural venous plexus on preprocedural imaging ( p < 0.001).

CONCLUSION: Back pain is one of the under-reported symptoms of IVC obstruction in BCS. IVC recanalization by IVC angioplasty with or without stenting relieves back pain due to the decompression of engorged epidural veins.

Original languageEnglish
Article number438
Issue number3
Publication statusPublished - Jan 25 2023


  • Budd–Chiari syndrome
  • IVC obstruction
  • IVC recanalization
  • back pain

ASJC Scopus subject areas

  • Clinical Biochemistry

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