Viatorr支架在TIPS治疗中的应用

Application of Viatorr stent in transjugular intrahepatic portosystemic shunt treatment

目的探讨使用Viatorr支架行经颈静脉肝内门体分流(TIPS)治疗门脉高压并食管胃底静脉曲张破裂出血的临床疗效。方法收集昆明医科大学第二附属医院放射科介入室自2016年10月1日至2017年11月30日使用GORE VIATORR誖覆膜支架系统完成TIPS术的肝硬化门脉高压患者46例,均置入1枚Viatorr支架,直径为8 mm。结果 Viatorr支架植入成功率100%,门静脉压力由(34.81±6.75) cmH_2O(1 cmH_2O=0.098 kPa)降至(22.93±6.24) cmH_2O。随访时间为1周～12个月。随访期间,1例患者因肝性脑病死亡,1例患者因口底恶性肿瘤死亡,8例患者出现肝性脑病,1例患者术后再出血。所有患者支架血流通畅。结论 Viatorr支架在TIPS治疗中安全、有效。

Objective To evaluate the clinical efficacy of transjugular intrahepatic portosystemic shunt(TIPS)by using Viatorr stent in treating portal hypertension complicated by gastroesophageal variceal haemorrhage.Methods A total of 46 patients with portal hypertension due to cirrhosis,who received TIPS by using GORE VIATORR TIPS covered stent system during the period from October 1,2016 to November30,2017 at Intervention Room,Second Affiliated Hospital of Kunming Medical University,China,were collected.Single Viatorr stent of 8 mm diameter was implanted in each patient.Results The technical success rate of Viatorr stent implantation was 100%.The portal venous pressure decreased from preoperative(34.81±6.75)cm H2O to postoperative(22.93±6.24)cm H2O.The patients were followed up for one week to12 months.During the follow-up period,one patient died of hepatic encephalopathy,another patient died of malignant tumor of oral floor,8 patients developed hepatic encephalopathy,and one patient had postoperative re-bleeding.Stent flow was unobstructed in all patients.Conclusion In treating portal hypertension complicated by gastroesophageal variceal haemorrhage with TIPS,the use of Viatorr stent is safe and effective.