Department of Interventional Radiology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technolgy, Luoyang 471000, Henan Province, China.
Department of Interventional Radiology, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471000, Henan Province, China.
World J Gastroenterol. 2018 Oct 21;24(39):4482-4488. doi: 10.3748/wjg.v24.i39.4482.
To evaluate the safety and efficacy of agitation thrombolysis (AT) combined with catheter-directed thrombolysis (CDT) for the treatment of non-cirrhotic acute portal vein thrombosis (PVT).
Nine patients with non-cirrhotic acute PVT who underwent AT combined with CDT were analyzed retrospectively. Portography was carried out the transjugular intrahepatic portosystemic (commonly known as TIP) or percutaneous transhepatic (commonly known as PT) route, followed by AT combined with CDT. Complications of the procedure, and the changes in clinical symptoms, hemodynamics of the portal vein and liver function were recorded. Follow-up was scheduled at 1, 3 and 6 mo after treatment, and every 6 mo thereafter, or when the patients developed clinical symptoms related to PVT. Color Doppler ultrasound and contrast-enhanced computed tomography/magnetic resonance imaging were performed during the follow-up period to determine the condition of the portal vein.
AT combined with CDT was successfully performed. The portal vein was reached the TIP route in 6 patients, and the PT route in 3 patients. All clinical symptoms were relieved or disappeared, with the exception of 1 patient who died of intestinal necrosis 9 d after treatment. Significant differences in the changes in portal vein hemodynamics were observed, including the maximum lumen occupancy of PVT, portal vein pressure and flow velocity between pre- and post-treatment ( < 0.05). During the follow-up period, recurrence was observed in 1 patient at 19 mo after the procedure, and the portal vein was patent in the remaining patients.
AT combined with CDT is a safe and effective method for the treatment of non-cirrhotic acute PVT.
评估搅拌溶栓（AT）联合导管定向溶栓（CDT）治疗非肝硬化性急性门静脉血栓（PVT）的安全性和有效性。
回顾性分析 9 例接受 AT 联合 CDT 治疗的非肝硬化性急性 PVT 患者。经经颈静脉肝内门体分流术（通常称为 TIP）或经皮经肝途径行门静脉造影，然后行 AT 联合 CDT。记录手术并发症，以及临床症状、门静脉血流动力学和肝功能变化。治疗后 1、3 和 6 个月及此后每 6 个月进行随访，或当患者出现与 PVT 相关的临床症状时进行随访。随访期间行彩色多普勒超声和增强计算机断层扫描/磁共振成像检查以确定门静脉情况。
AT 联合 CDT 成功实施。6 例患者经 TIP 途径，3 例患者经 PT 途径到达门静脉。除 1 例患者治疗后 9 天死于肠坏死外，所有临床症状均缓解或消失。门静脉血流动力学变化差异有统计学意义，包括 PVT 最大管腔占有率、门静脉压力和流速的变化（<0.05）。随访期间，1 例患者在术后 19 个月复发，其余患者门静脉通畅。
AT 联合 CDT 是治疗非肝硬化性急性 PVT 的一种安全有效的方法。
