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肝移植术后小儿患者肝周血管狭窄或闭塞的介入放射学治疗。

Interventional radiological treatment of perihepatic vascular stenosis or occlusion in pediatric patients after liver transplantation.

机构信息

Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany.

KUNO University Children's Hospital Regensburg, University Medical Center Regensburg, 93053, Regensburg, Germany.

出版信息

Cardiovasc Intervent Radiol. 2013 Dec;36(6):1562-1571. doi: 10.1007/s00270-013-0595-1. Epub 2013 Apr 10.

Abstract

PURPOSE

Evaluation of the efficacy and safety of percutaneous treatment of vascular stenoses and occlusions in pediatric liver transplant recipients.

METHODS

Fifteen children (mean age 8.3 years) underwent interventional procedures for 18 vascular complications after liver transplantation. Patients had stenoses or occlusions of portal veins (n = 8), hepatic veins (n = 3), inferior vena cava (IVC; n = 2) or hepatic arteries (n = 5). Technical and clinical success rates were evaluated.

RESULTS

Stent angioplasty was performed in seven cases (portal vein, hepatic artery and IVC), and sole balloon angioplasty was performed in eight cases. One child underwent thrombolysis (hepatic artery). Clinical and technical success was achieved in 14 of 18 cases of vascular stenoses or occlusions (mean follow-up 710 days).

CONCLUSION

Pediatric interventional radiology allows effective and safe treatment of vascular stenoses after pediatric liver transplantation (PLT). Individualized treatment with special concepts for each pediatric patient is necessary. The variety, the characteristics, and the individuality of interventional management of all kinds of possible vascular stenoses or occlusions after PLT are shown.

摘要

目的

评估经皮治疗小儿肝移植受者血管狭窄和闭塞的疗效和安全性。

方法

15 名儿童(平均年龄 8.3 岁)在肝移植后因 18 种血管并发症接受介入治疗。患者存在门静脉狭窄或闭塞(n=8)、肝静脉狭窄或闭塞(n=3)、下腔静脉狭窄或闭塞(n=2)或肝动脉狭窄或闭塞(n=5)。评估技术和临床成功率。

结果

在 7 例(门静脉、肝动脉和下腔静脉)中进行了支架血管成形术,在 8 例中进行了单纯球囊血管成形术。1 例患儿接受了溶栓治疗(肝动脉)。18 例血管狭窄或闭塞中,有 14 例(平均随访 710 天)获得临床和技术成功。

结论

儿科介入放射学可有效、安全地治疗小儿肝移植后的血管狭窄(PLT)。需要针对每个儿科患者制定个体化治疗方案。本文展示了 PLT 后各种可能的血管狭窄或闭塞的介入治疗的多样性、特点和个体化。

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