Dollinger M, Goessmann H, Mueller-Wille R, Wohlgemuth W A, Stroszczynski C, Heiss P
Rofo. 2014 Feb;186(2):142-50. doi: 10.1055/s-0033-1350514. Epub 2013 Oct 14.
To report on first results of the embolization of transhepatic and transsplenic puncture tracts using an Amplatzer Vascular Plug (AVP) after percutaneous portal vein intervention.
Embolization of transhepatic and transsplenic puncture tracts with AVP was attempted in 5 patients (3 females; age range: 3 - 71 years). Portal vein access was gained by a transhepatic (n = 4) or transsplenic (n = 1) approach, and stenosis (n = 2) or thrombosis (n = 3) of the portal vein was successfully treated by percutaneous stenting or thrombus aspiration and thrombolysis using 6 to 10 French sheaths. Due to the relatively large bore and/or short transparenchymal puncture tracts, it was considered favorable to use AVPs as an embolic agent. The medical records, the radiological reports and images of these 5 patients were retrospectively evaluated.
In three cases one AVP II (diameter, 4 mm), in one case one AVP IV (diameter, 4 mm) and in one case two AVPs II (diameter, 8 and 6 mm) were used for embolization of the puncture tract. In all five cases embolization was technically successful. There was no bleeding from the puncture tract. During a median follow-up of 14 months (range, 21 days to 21 months), one patient developed a focal liver abscess adjacent to the AVP which was successfully treated by antimicrobial and drainage therapy. There were no further embolization-related complications.
AVPs are suited to embolize large bore and/or short transhepatic and transsplenic puncture tracts effectively, safely, and precisely. Caution is required in patients with an increased risk for infectious complications.
• Embolization of transhepatic and transsplenic puncture tracts with AVPs is feasible• Large and/or short puncture tracts can be effectively embolized with AVPs• The risk of infectious complications has to be considered Citation Format: • Dollinger M, Goessmann H, Mueller-Wille R et al. Percutaneous Transhepatic and Transsplenic Portal Vein Access: Embolization of the Puncture Tract Using Amplatzer Vascular Plugs. Fortschr Röntgenstr 2014; 186: 142 - 150.
报告经皮门静脉介入术后使用Amplatzer血管封堵器（AVP）栓塞经肝和经脾穿刺通道的初步结果。
对5例患者（3例女性；年龄范围：3至71岁）尝试使用AVP栓塞经肝和经脾穿刺通道。通过经肝途径（n = 4）或经脾途径（n = 1）建立门静脉通路，使用6至10F鞘管经皮支架置入或血栓抽吸及溶栓成功治疗门静脉狭窄（n = 2）或血栓形成（n = 3）。由于穿刺通道孔径相对较大和/或实质穿刺通道较短，认为使用AVP作为栓塞剂较为合适。对这5例患者的病历、放射学报告及影像进行回顾性评估。
3例使用1枚AVP II（直径4mm），1例使用1枚AVP IV（直径4mm），1例使用2枚AVP II（直径8mm和6mm）栓塞穿刺通道。所有5例栓塞技术均成功。穿刺通道无出血。中位随访14个月（范围：21天至21个月），1例患者在AVP附近发生局灶性肝脓肿，经抗菌及引流治疗成功。无其他与栓塞相关的并发症。
AVP适合有效、安全且精确地栓塞大孔径和/或短的经肝及经脾穿刺通道。对于感染并发症风险增加的患者需谨慎。
• 使用AVP栓塞经肝和经脾穿刺通道是可行的• AVP可有效栓塞大的和/或短的穿刺通道• 必须考虑感染并发症的风险 引用格式：• Dollinger M, Goessmann H, Mueller-Wille R等。经皮经肝和经脾门静脉通路：使用Amplatzer血管封堵器栓塞穿刺通道。Fortschr Röntgenstr 2014; 186: 142 - 150。
