A 31-year-old woman presented to our emergency department with an acute liver injury secondary to acute Budd-Chiari (BC) syndrome from hepatic vein thrombosis. After a thorough discussion of the risks involved, we proceeded to treatment with a novel approach, performing a mechanical hepatic vein thrombectomy with the AngioJet percutaneous thrombectomy system. Restoration of hepatic vein flow was confirmed with on-table Doppler ultrasound. There were no complications following the procedure. The patient was initiated on anticoagulation, and showed progressive clinical and laboratory improvement. She was discharged home on day 20 with normal liver function and biochemistry. This is the first reported case of successful mechanical thrombectomy in acute BC syndrome without the addition of angioplasty or chemical thrombolysis.
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