Transhepatic catheter-directed thrombolysis for portal vein thrombosis after partial splenic embolization in combination with balloon-occluded retrograde transvenous obliteration of splenorenal shunt

一个 66 岁的女人与自发的门静脉高血压(IPH ) 为脾机能亢进经历了部分脾的 embolization (PSE ) 。一个星期以后，提高对比的 CT 揭示了广泛的门静脉血栓(PVT ) 并且扩大了 portosystemic 分流。PVT 没被尿激的静脉内的管理溶解。正确的门静脉是经由在超声的指导和 4 Fr 下面的经皮的 transhepatic 线路的 canulated。直导管通过血栓被推进进门静脉。Transhepatic 指导导管的血栓溶解被执行溶解 PVT， splenorenal 分流并发地被堵塞增加门血流，用堵塞汽球后退 transvenous 涂去(BRTO ) 技术。随后的提高对比的 CT 显示出门静脉和形成血栓 splenorenal 分流的好明显。与 BRTO 相结合的 Transhepatic 指导导管的血栓溶解为有 portosystemic 分流的 PVT 可行、有效。

A 66-year-old woman underwent partial splenic embolization （PSE） for hypersplenisrn with idiopathic portal hypertension （IPH）. One week later, contrast-enhanced CT revealed extensive portal vein thrombosis （PVT） and dilated portosystemic shunts. The PVT was not dissolved by the intravenous administration of urokinase. The right portal vein was canulated via the percutaneous transhepatic route under ultrasonic guidance and a 4 Fr. straight catheter was advanced into the portal vein through the thrombus. Transhepatic catheter-directed thrombolysis was performed to dissolve the PVT and a splenorenal shunt was concurrently occluded to increase portal blood flow, using balloon-occluded retrograde transvenous obliteration （BRTO） technique. Subsequent contrast-enhanced CT showed good patency of the portal vein and thrombosed splenorenal shunt. Transhepatic catheter-directed thrombolysis combined with BRTO is feasible and effective for PVT with portosystemic shunts.