Racadio John M, Sheyn David D, Neely John C, Racadio Judy M, Vu Doan N
Division of Pediatric Interventional Radiology, Department of Radiology, Cincinnati Childrens Hospital Medical Center, 3333 Burnet Ave, Cincinnati, Ohio 45229, USA.
J Vasc Interv Radiol. 2007 Jun;18(6):781-4. doi: 10.1016/j.jvir.2007.02.001.
Arterioportal fistulas may occur in liver transplant recipients after percutaneous biopsy. This report describes a case in which a 13-year-old liver transplant patient developed an arterioportal fistula after multiple liver biopsies and underwent coil embolization; however, at that time, there were at least two small arterial feeders that were not amenable to subselection. He later developed recurrent variceal bleeding, and repeat angiogram revealed multiple tiny serpentine feeding arteries. Because these arteries could not be subselectively catheterized, the collagen-thrombin mixture, D-Stat, was used to occlude the portal venous outflow of the arterioportal fistula. Subsequent angiography demonstrated successful complete occlusion of the arterioportal fistula.
肝动脉门静脉瘘可能发生在肝移植受者经皮肝穿刺活检后。本报告描述了一例13岁的肝移植患者，在多次肝活检后发生肝动脉门静脉瘘，并接受了弹簧圈栓塞治疗；然而，当时至少有两条小动脉供血支无法进行超选择性插管。他后来出现复发性静脉曲张出血，再次血管造影显示有多个微小的蜿蜒状供血动脉。由于这些动脉无法进行超选择性插管，因此使用胶原-凝血酶混合物D-Stat来闭塞肝动脉门静脉瘘的门静脉流出道。随后的血管造影显示肝动脉门静脉瘘成功完全闭塞。
