经颈静脉肝内门体分流道并行分流术治疗经颈静脉肝内门体分流道功能障碍
Parallel shunt for the treatment of transjugular intrahepatic portosystemic shunt dysfunction.
机构信息
Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, China.
出版信息
Korean J Radiol. 2013 May-Jun;14(3):423-9. doi: 10.3348/kjr.2013.14.3.423. Epub 2013 May 2.
OBJECTIVE
To investigate the safety, efficacy and long-term patency of parallel shunts (PS) in the management of the transjugular intrahepatic portosystemic shunt (TIPS) dysfunction.
MATERIALS AND METHODS
Between March 2007 and October 2010, 18 patients (13 men and 5 women) who underwent TIPS revision with the creation of PS were evaluated retrospectively. In the first 10 patients, a 10-mm-diameter Wallgraft endoprosthesis was deployed; in the latter 8 patients, an 8-mm-diameter Fluency endoprosthesis was deployed.
RESULTS
The creation of PS was technically successful in all patients. The mean ± standard deviation portosystemic pressure gradient before and after the procedure was 25.5 ± 7.3 mm Hg (range, 16-37 mm Hg) and 10.9 ± 2.3 mm Hg (range, 7-16 mm Hg), respectively. The duration of follow-up was 16.7 ± 10.8 months (range, 6-42 months). The primary shunt patency rates at 12 months after the creation of PS was 70% with Wallgraft endoprostheses and 87.5% with Fluency endoprostheses.
CONCLUSION
TIPS revision with the creation of PS is a safe, effective and durable method for treating shunt dysfunction.
目的
研究平行分流术（PS）在经颈静脉肝内门体分流术（TIPS）功能障碍管理中的安全性、疗效和长期通畅率。
材料与方法
回顾性评估了 2007 年 3 月至 2010 年 10 月期间 18 例接受 TIPS 修正术并创建 PS 的患者。在前 10 例患者中，使用了 10mm 直径的 Wallgraft 支架；在后 8 例患者中，使用了 8mm 直径的 Fluency 支架。
结果
所有患者均成功完成了 PS 的创建。术前和术后的平均±标准差门静脉系统压力梯度分别为 25.5±7.3mmHg（范围，16-37mmHg）和 10.9±2.3mmHg（范围，7-16mmHg）。随访时间为 16.7±10.8 个月（范围，6-42 个月）。使用 Wallgraft 支架的 PS 术后 12 个月的主要分流通畅率为 70%，使用 Fluency 支架的为 87.5%。
结论
TIPS 修正术联合 PS 是一种安全、有效且持久的治疗分流功能障碍的方法。
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