Widrich W C, Johnson W C, Robbins A H, Nabseth D C
Arch Surg. 1978 Nov;113(11):1331-8. doi: 10.1001/archsurg.1978.01370230121015.
The angiographic technique percutaneous transhepatic coronary vein occlusion was used to treat esophagogastric variceal bleeding in 38 patients. There were two categories of patients: those actively bleeding who had not been controlled by continuous vasopressin infusion and/or Blakemore tube tamponade, and those with portal hypertension who were not actively bleeding at the time of transhepatic portal venography but who were at high risk for recurrent variceal hemorrhage. Coronary vein occlusion was achieved in 33 patients by (1) metal clip and cotton devices(one); (2) balloon catheter occlusion (two); (3) heat-treated autogenous clot and powdered absorbable gelatin sponge (Gelfoam) (13); and (4) Gelfoam strips soaked in sodium tetradecyl sulfate (17). Percutaneous coronary vein occlusion was effective in controlling 81% of the patients with actively bleeding varices. In patients who were not actively bleeding, percutaneous transhepatic coronary vein occlusion seemed to afford good protection for recurrent variceal hemorrhage.
采用经皮经肝冠状静脉闭塞血管造影技术治疗38例食管胃静脉曲张出血患者。患者分为两类：一类是经持续输注血管加压素和/或使用Blakemore管压迫仍无法控制的活动性出血患者；另一类是经肝门静脉造影时无活动性出血，但有静脉曲张再出血高风险的门静脉高压患者。33例患者实现了冠状静脉闭塞，方法如下：（1）金属夹和棉塞装置（1例）；（2）球囊导管闭塞（2例）；（3）热处理的自体血凝块和可吸收明胶海绵粉（明胶海绵）（13例）；（4）浸泡在十四烷基硫酸钠中的明胶海绵条（17例）。经皮冠状静脉闭塞术对81%的活动性静脉曲张出血患者止血有效。对于无活动性出血的患者，经皮经肝冠状静脉闭塞术似乎能为预防静脉曲张再出血提供良好的保护。
