摘要
To evaluate the clinical value of various kinds of interventional techniques in the treatment of Budd-Chiari syndrome (BCS) Methods Multiple techniques such as recanalization of the inferior vena cava (IVC) under the guidance of marker and multi-angled fluoroscopy, recanalization of the hepatic vein with a transjugular approach, PTA, Z-expandable metallic stent (Z-EMS) implantation and modified TIPSS were used to treat 103 patients with BCS Results Of 103 patients with BCS, 59 patients with obstruction of IVC were treated usi ng recanalization of IVC Seventeen patients with hepatic vein obstruction had their hepatic veins recanalized The rest of the patients were given other methods of interventional treatment Of all the subjects, 101 successfully underwent their procedures, with a success rate of 98 06%; and only 2 failed to recanaliz ation of the IVC Fifty-three patients were treated using PTA for the first time, with a success rate of 100% In the 48 patients undergoing Z-EMS implantation for the first time, the success rate was 95 8% Five patients were treated with modified TIPSS After these interventional treatments, the success rate was 100% Two patients died 16 h and 72 h respectiv ely after operation because of DIC and severe hemoptysis Seventy-two patients were followed up for 1-94 months (with a mean of 42 3 months). The mean fol low-up of a BCS patient treated with PTA was 52 1 months, resulting in a prima ry patent rate of 59 4% and a restenosis rate of 40 6% The mean follow-up of BCS treated with stenting was 33 5 months, with a primary patent rate of 87 5% and a restenosis rate of 12 5% Eight patients died 7-64 months after the interventional procedure Conclusion Recanalization of IVC or the hepatic vein transjugularly, PTA, Z-EMS implantation and modified TIPSS can be regarded as safe and effective micro-invasive methods in the treatment of BCS
To evaluate the clinical value of various kinds of interventional techniques in the treatment of Budd-Chiari syndrome (BCS) Methods Multiple techniques such as recanalization of the inferior vena cava (IVC) under the guidance of marker and multi-angled fluoroscopy, recanalization of the hepatic vein with a transjugular approach, PTA, Z-expandable metallic stent (Z-EMS) implantation and modified TIPSS were used to treat 103 patients with BCS Results Of 103 patients with BCS, 59 patients with obstruction of IVC were treated usi ng recanalization of IVC Seventeen patients with hepatic vein obstruction had their hepatic veins recanalized The rest of the patients were given other methods of interventional treatment Of all the subjects, 101 successfully underwent their procedures, with a success rate of 98 06%; and only 2 failed to recanaliz ation of the IVC Fifty-three patients were treated using PTA for the first time, with a success rate of 100% In the 48 patients undergoing Z-EMS implantation for the first time, the success rate was 95 8% Five patients were treated with modified TIPSS After these interventional treatments, the success rate was 100% Two patients died 16 h and 72 h respectiv ely after operation because of DIC and severe hemoptysis Seventy-two patients were followed up for 1-94 months (with a mean of 42 3 months). The mean fol low-up of a BCS patient treated with PTA was 52 1 months, resulting in a prima ry patent rate of 59 4% and a restenosis rate of 40 6% The mean follow-up of BCS treated with stenting was 33 5 months, with a primary patent rate of 87 5% and a restenosis rate of 12 5% Eight patients died 7-64 months after the interventional procedure Conclusion Recanalization of IVC or the hepatic vein transjugularly, PTA, Z-EMS implantation and modified TIPSS can be regarded as safe and effective micro-invasive methods in the treatment of BCS
基金
ThisstudywassupportedbyagrantfromtheNational"95"ScientificFoundation(No.9690 70 1 0 2 )
