不同球囊导管治疗下腔静脉阻塞的回顾性分析

A retrospective analysis of different balloon catheters for the treatment of inferior vena cava obstruction

目的 探讨不同球囊导管治疗肝段下腔静脉阻塞的效果和选择要点。方法 分别选用聚乙烯 18mm、2 0mm球囊和Inoue 2 4mm、2 6mm球囊对 48例肝段下腔静脉阻塞患者进行经皮血管腔内成形术 (PTA) ,9例放置血管内支架。术前术后行下腔静脉造影并测量、计算下腔静脉至右心房压力阶差。结果 PTA术后下腔静脉内径由 (1.9± 0 .4)mm增至 (18.3± 6.3 )mm。下腔静脉压由 (3 .14± 0 .77)kPa降至 (1.50± 0 .53 )kPa。残余压力阶差聚乙烯 18mm球囊组、2 0mm球囊组分别为 (0 .77± 0 .3 2 )kPa、(0 .62± 0 .3 5)kPa ;Inoue 2 4mm球囊组、2 6mm球囊组分别为 (0 .3 4± 0 .2 7)kPa、(0 .2 4± 0 .2 5)kPa。结论 PTA是治疗肝段下腔静脉阻塞的有效方法 ,以大腔球囊对病变部位充分扩张是提高疗效。

ObjectiveTo study the eff ect and indication of different balloon catheters in percutaneous transluminal a ngioplasty (PTA) for treating suprahepatic inferior vena cava (IVC) obstruction syndrome. Methods48 patients with IVC obstruction syndr ome were treated by PTA with Polythene 18 mm, Polythene 20 mm, Inoue 24 mm, Inou e 26 mm balloon catheters, respectively. Stents were inserted in 9 cases. IVC an giograms were investigated. The IVC pressure and right atrial pressure were meas ured to calculate the pressure gradients before and after PTA. Result sThe diameter of IVC was increased from (1.9± 0.4) mm to (18.3 ±6.3) mm. The residual pressure gradient after PTA was reduced to (0.77±0.32) kPa in Polythene 18 mm group, (0.62±0.35) kPa in Polythene 20 mm group, (0.34± 0.27) kPa in Inoue 24 mm group and (0.24±0.25) kPa in Inoue 26 mm group, respec tively. ConclusionPTA (accompanied by stent in certain c ases) is an effective treatment for suprahepatic inferior vena cava obstruction. Suitable large balloon and effective dilatation are key to effective improvemen t of the syndrome and prevention of restenosis.