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肝移植术后肝动脉狭窄的经皮血管腔内治疗:经皮血管腔内治疗的作用

Percutaneous Endovascular Treatment for Hepatic Artery Stenosis after Liver Transplantation: The Role of Percutaneous Endovascular Treatment.

作者信息

Vidjak Vinko, Novačić Karlo, Matijević Filip, Kavur Lovro, Slavica Marko, Mrzljak Anna, Filipec-Kanižaj Tajana, Leder Nikola Ivan, Škegro Dinko

机构信息

Clinical Department of Diagnostic and Interventional Radiology, Merkur University Hospital, Zagreb, Croatia.

Queens and King George, Barking, Havering and Redbridge University Hospitals NHS Trust, London, U.K.

出版信息

Pol J Radiol. 2015 Jun 16;80:309-16. doi: 10.12659/PJR.893831. eCollection 2015.

Abstract

BACKGROUND

To retrospectively analyze the outcomes of interventional radiology treatment of patients with hepatic artery stenosis (HAS) after liver transplantation at our Institution.

MATERIAL/METHODS: Hepatic artery stenosis was diagnosed and treated by endovascular technique in 8 (2.8%) patients, who underwent liver transplantation between July 2007 and July 2011. Patients entered the follow-up period, during which we analyzed hepatic artery patency with Doppler ultrasound at 1, 3, 6, and 12 months after percutaneous endovascular treatment (PTA), and every six months thereafter.

RESULTS

During the 12-month follow-up period, 6 out of 8 patients (75%) were asymptomatic with patent hepatic artery, which was confirmed by multislice computed tomography (MSCT) angiography, or color Doppler (CD) ultrasound. One patient had a fatal outcome of unknown cause, and one patient underwent orthotopic liver retransplantation (re-OLT) procedure due to graft failure.

CONCLUSIONS

Our results suggest that HAS angioplasty and stenting are minimally invasive and safe endovascular procedures that represent a good alternative to open surgery, with good 12-month follow-up patency results comparable to surgery.

摘要

背景

回顾性分析我院肝移植术后肝动脉狭窄(HAS)患者的介入放射治疗结果。

材料/方法:2007年7月至2011年7月期间接受肝移植的8例(2.8%)患者通过血管内技术诊断并治疗肝动脉狭窄。患者进入随访期,在此期间,我们在经皮血管内治疗(PTA)后1、3、6和12个月以及此后每6个月用多普勒超声分析肝动脉通畅情况。

结果

在12个月的随访期内,8例患者中有6例(75%)无症状,肝动脉通畅,多层螺旋计算机断层扫描(MSCT)血管造影或彩色多普勒(CD)超声证实。1例患者不明原因死亡,1例患者因移植物衰竭接受原位肝再次移植(re-OLT)手术。

结论

我们的结果表明,HAS血管成形术和支架置入术是微创且安全的血管内手术,是开放手术的良好替代方案,12个月的随访通畅结果良好,与手术相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5abf/4476501/f05021d4e2c5/poljradiol-80-309-g001.jpg

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