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支架置入治疗肝移植术后下腔静脉狭窄的长期疗效。

Long-term efficacy of stent placement for treating inferior vena cava stenosis following liver transplantation.

机构信息

Inje University Paik Hospital, Radiology, Seoul, Korea.

出版信息

Liver Transpl. 2010 Apr;16(4):513-9. doi: 10.1002/lt.22021.

Abstract

The aims of this study were to evaluate both the efficacy of stent placement for treating inferior vena cava (IVC) stenosis and the patency of hepatic veins (HVs) following IVC stent placement. Fourteen hepatic transplant recipients underwent stent placement to treat IVC stenosis. The median interval between transplantation and stent placement was 32 days. Stents varied from 20-36 mm in diameter and were 60-120 mm long. We retrospectively analyzed the technical and clinical success, changes of hepatic venous flow, and the patency of the IVC stents. Stent placement was successful in all patients. Clinical success was achieved in 12 patients. Four patients underwent HV balloon angioplasty or stent placement through IVC stent meshes either immediately (n = 1) or 12-110 days after (n = 3) IVC stent placement. Nine of the 12 patients were healthy when this manuscript was completed, and the last follow-up computed tomography scan obtained at a median of 65.3 months after IVC stent placement revealed the patency of the stent-placed IVC and HVs. IVC stent placement seems to be an effective treatment with an excellent, long-term patency for treating posttransplant stenosis, although the possibility of hepatic venous outflow abnormalities following IVC stent placement should also be considered.

摘要

本研究旨在评估支架置入术治疗下腔静脉(IVC)狭窄的疗效以及 IVC 支架置入术后肝静脉(HV)的通畅性。14 例肝移植受者因 IVC 狭窄而行支架置入术。移植与支架置入的中位时间间隔为 32 天。支架直径为 20-36mm,长度为 60-120mm。我们回顾性分析了技术和临床成功率、肝静脉血流变化以及 IVC 支架的通畅性。所有患者的支架置入均成功。12 例患者中,12 例临床成功。4 例患者在行 IVC 支架置入术后 12-110 天(n=3)或即刻(n=1)行 HV 球囊扩张或支架置入术。在本研究报告完成时,12 例患者中有 9 例健康,IVC 支架置入后中位 65.3 个月的最后一次随访 CT 扫描显示支架置入的 IVC 和 HV 通畅。尽管 IVC 支架置入后可能出现肝静脉流出异常,但 IVC 支架置入术治疗移植后狭窄似乎是一种有效且长期通畅的治疗方法。

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