Zhang Chun-Qing, Fu Li-Na, Xu Lin, Zhang Guo-Quan, Jia Tao, Liu Ji-Yong, Qin Cheng-Yong, Zhu Ju-Ren
Department of Gastroenterology, Shandong Provincial Hospital, Jinan 250021, Shandong Province, China.
World J Gastroenterol. 2003 Nov;9(11):2587-91. doi: 10.3748/wjg.v9.i11.2587.
To report the long-term effect of stent placement in 115 patients with Budd-Chiari syndrome (BCS).
One hundred and fifteen patients with BCS were treated by percutaneous stent placement. One hundred and two patients had IVC stent placement, 30 patients had HV stent placement, 17 of them underwent both IVC stent and HV stent. All the procedures were performed with guidance of ultrasound.
The successful rates in placing IVC stent and HV stent were 94% (96/102) and 87% (26/30), respectively. Ninety-seven patients with 112 stents (90 IVC stents, 22 HV stents) were followed up. 96.7% (87/90) IVC stents and 90.9% (20/22) HV stents remained patent during follow up periods (mean 49 months, 45 months, respectively). Five of 112 stents in the 97 patients developed occlusion. Absence of anticoagulants after the procedure and types of obstruction (segmental and occlusive) before the procedure were related to a higher incidence of stent occlusion.
Patients with BCS caused by short length obstruction can be treated by IVC stent placement, HV stent placement or both IVC and HV stent placement depending on the sites of obstruction. The long-term effect is satisfactory. Anticoagulants are strongly recommended after the procedure especially for BCS patients caused by segmental occlusion.
报告115例布加综合征(BCS)患者支架置入的长期效果。
115例BCS患者接受经皮支架置入治疗。102例患者置入下腔静脉(IVC)支架,30例患者置入肝静脉(HV)支架,其中17例同时接受IVC和HV支架置入。所有操作均在超声引导下进行。
IVC支架和HV支架置入的成功率分别为94%(96/102)和87%(26/30)。对97例置入112枚支架(90枚IVC支架,22枚HV支架)的患者进行随访。随访期间,96.7%(87/90)的IVC支架和90.9%(20/22)的HV支架保持通畅(平均分别为49个月和45个月)。97例患者的112枚支架中有5枚发生闭塞。术后未使用抗凝剂以及术前梗阻类型(节段性和闭塞性)与支架闭塞发生率较高有关。
由短段梗阻引起的BCS患者可根据梗阻部位选择IVC支架置入、HV支架置入或IVC和HV支架联合置入。长期效果令人满意。强烈建议术后使用抗凝剂,尤其是对于由节段性闭塞引起的BCS患者。