Fu Yu-Fei, Wei Ning, Wu Qian, Zhang Qing-Qiao, Cui Yan-Feng, Xu Hao
Department of Radiology, Xuzhou Central Hospital, 199 Jie-fang Road, Xuzhou, Jiangsu, 221009, China.
Department of Interventional Radiology, Affiliated Hospital of Xuzhou Medical College, 99 West Huai-hai Road, Xuzhou, Jiangsu, 221006, China.
Cardiovasc Intervent Radiol. 2015 Dec;38(6):1508-14. doi: 10.1007/s00270-015-1105-4. Epub 2015 Apr 23.
To evaluate the clinical value of accessory hepatic vein (AHV) intervention in the treatment of Budd-Chiari syndrome (BCS).
From August 2008 to July 2014, consecutive patients with BCS caused by obstruction of three hepatic veins (HVs) with or without obstruction of inferior vena cava (IVC) were treated by recanalization or transjugular intrahepatic portosystemic shunt in our center. Patients who had the compensatory AHV and successfully underwent recanalization of AHV outflow were enrolled in this retrospective study. The clinical response to AHV drainage was analyzed.
Compensatory AHV was found in 69 of 97 (71.1%) patients, and 66 patients successfully underwent recanalization of AHV outflow (IVC recanalization, n = 49; AHV recanalization, n = 15; both, n = 2). In total, 78 AHVs were used instead of HV as the hepatic drainage vein after treatment. Fifty-five patients had one AHV, 10 patients had two AHVs, and 1 patient had three AHVs. The average diameter of all AHV stems was 8.0 ± 2.6 mm (range 5-21 mm). Clinical response to AHV drainage was positive in all patients. Patients' symptoms and liver function improved progressively after treatment. During the follow-up of 3-74 months (average 39.4 ± 11.0 months), 11 patients experienced reobstruction at 6 to 36 months (average 16.8 ± 9.8 months) after treatment.
Compensatory AHV can be effectively used instead of HV for drainage of hepatic blood in patients with BCS. AHV intervention can help to simplify the BCS treatment procedure.
评估副肝静脉（AHV）介入治疗布加综合征（BCS）的临床价值。
2008年8月至2014年7月，在本中心对连续性的由三条肝静脉（HV）阻塞伴或不伴下腔静脉（IVC）阻塞引起的BCS患者采用再通或经颈静脉肝内门体分流术进行治疗。有代偿性AHV且成功进行AHV流出道再通的患者纳入本回顾性研究。分析AHV引流的临床反应。
97例患者中有69例（71.1%）发现有代偿性AHV，66例患者成功进行了AHV流出道再通（IVC再通49例；AHV再通15例；两者均再通2例）。治疗后共使用78条AHV替代HV作为肝引流静脉。55例患者有1条AHV，10例患者有2条AHV，1例患者有3条AHV。所有AHV主干的平均直径为8.0±2.6mm（范围5 - 21mm）。所有患者对AHV引流的临床反应均为阳性。治疗后患者症状及肝功能逐渐改善。在3至74个月（平均39.4±11.0个月）的随访期间，11例患者在治疗后6至36个月（平均16.8±9.8个月）出现再阻塞。
代偿性AHV可有效替代HV用于BCS患者的肝血引流。AHV介入有助于简化BCS的治疗程序。
