Thouveny Francine, Aubé Christophe, Konaté Anselme, Lebigot Jérôme, Bouvier Antoine, Oberti Frédéric
Department of Radiology, Centre Hospitalier Universitaire Angers, 49933 Angers Cedex 09, France.
J Vasc Interv Radiol. 2008 May;19(5):774-7. doi: 10.1016/j.jvir.2008.01.018. Epub 2008 Mar 17.
The present report describes the authors' experience with direct endoluminal embolization for bleeding stomal varices. Between December 1998 and July 2006, seven patients with enterostomies, portal hypertension, and recurrent stomal variceal bleeding resistant to medical treatment were treated at a single institution. Ultrasonography was used to guide direct puncture of the varices. Direct endoluminal embolization with cyanoacrylate glue was performed under fluoroscopic control imaging. Embolization was successful in six of seven cases. One patient with hepatocellular carcinoma and complete portal thrombosis had three recurrences treated with the same technique, with clinical success. Three patients died at 3, 8, and 18 months without recurrence of bleeding. Although further evaluation is indicated, direct percutaneous embolization appears to be a potential alternative treatment for bleeding stomal varices.
本报告描述了作者对出血性造口静脉曲张进行直接腔内栓塞的经验。1998年12月至2006年7月期间，一家机构对7例有肠造口、门静脉高压且药物治疗无效的复发性造口静脉曲张出血患者进行了治疗。使用超声引导对静脉曲张进行直接穿刺。在荧光透视控制成像下用氰基丙烯酸酯胶进行直接腔内栓塞。7例中有6例栓塞成功。1例肝细胞癌合并完全门静脉血栓形成的患者用相同技术治疗了3次复发，临床成功。3例患者分别在3个月、8个月和18个月时死亡，未再出血。尽管需要进一步评估，但直接经皮栓塞似乎是出血性造口静脉曲张的一种潜在替代治疗方法。
