Zhou Peng-Li, Wu Gang, Han Xin-Wei, Yan Lei, Zhang Wen-Guang
Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
Vascular. 2017 Dec;25(6):642-648. doi: 10.1177/1708538117710087. Epub 2017 Jun 13.
Purpose To identify the characteristics and evaluate the long-term outcomes of endovascular treatment of Budd-Chiari syndrome with upper gastrointestinal hemorrhage. Methods Forty-seven consecutive Budd-Chiari syndrome patients with upper gastrointestinal hemorrhage were referred for the treatment with percutaneous transluminal balloon angioplasty, and subsequently underwent follow-up. Data were retrospectively collected and follow-up observations were performed at 1, 2, 2-5, and 5-8 years postoperatively. Results Cirrhosis was presented in 16 patients, and splenoportography reviewed obvious varices in 18 patients. Percutaneous transluminal balloon angioplasty was technically successful in all patients. Major procedure-related complications occurred in 3 of the 47 patients (6.38%). The cumulative 1, 2, 2-5, and 5-8 year primary patency rates were 100% (46/46), 93.2% (41/44), 90.9% (40/44), and 86.4% (19/22), respectively. The cumulative 1, 2, 2-5, and 5-8 year secondary patency rates were 100% (47/47), 100% (44/44), 100% (44/44), and 95.5% (21/22), respectively. Mean and median duration of primary patency was 65.17 ± 3.78 and 69.0 ± 5.69 months, respectively. No upper gastrointestinal hemorrhage recurred during follow-ups. The mean survival time was 66.97 ± 3.61 months and the median survival time was 69.0 ± 4.10 months. Conclusion PTBA was an effective treatment that can prevent recurrence of the life-threatening complications and ensured long-term satisfactory clinical outcomes for Budd-Chiari syndrome patients with upper gastrointestinal hemorrhage. Percutaneous transhepatic variceal embolization was not recommended for all Budd-Chiari syndrome patients with upper gastrointestinal hemorrhage.
目的 确定布加综合征合并上消化道出血的血管内治疗特点并评估其长期疗效。方法 连续47例布加综合征合并上消化道出血患者接受经皮腔内球囊血管成形术治疗，随后进行随访。回顾性收集数据，并在术后1年、2年、2至5年和5至8年进行随访观察。结果 16例患者出现肝硬化，18例患者脾门静脉造影显示明显静脉曲张。所有患者经皮腔内球囊血管成形术技术均成功。47例患者中有3例（6.38%）发生主要的与手术相关的并发症。1年、2年、2至5年和5至8年的累积原发性通畅率分别为100%（46/46）、93.2%（41/44）、90.9%（40/44）和86.4%（19/22）。1年、2年、2至5年和5至8年的累积继发性通畅率分别为100%（47/47）、100%（44/44）、100%（44/44）和95.5%（21/22）。原发性通畅的平均和中位持续时间分别为65.17±3.78个月和69.0±5.69个月。随访期间无复发性上消化道出血。平均生存时间为66.97±3.61个月，中位生存时间为69.0±4.10个月。结论 经皮腔内球囊血管成形术是一种有效的治疗方法，可预防危及生命的并发症复发，并为布加综合征合并上消化道出血患者确保长期满意的临床疗效。不建议对所有布加综合征合并上消化道出血患者进行经皮肝穿门静脉栓塞术。
