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经颈静脉肝内门体分流术中门静脉靶向技术。

Techniques for portal vein targeting during a transjugular intrahepatic portosystemic shunt.

机构信息

Louisiana State University Health Sciences Center, Department of Radiology, Division of Interventional Radiology, Los Angeles, USA

出版信息

Diagn Interv Radiol. 2024 Jan 8;30(1):42-47. doi: 10.4274/dir.2022.221539. Epub 2022 Dec 21.

DOI:10.4274/dir.2022.221539
PMID:36994881
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10773176/
Abstract

A transjugular intrahepatic portosystemic shunt (TIPS) is one of the most challenging procedures in interventional radiology. Hepatic and portal venous anatomy can be highly variable, and access to the portal vein, which can be quite difficult even for experienced surgeons, is the most critical step in a TIPS. Although there are multiple techniques to achieve a portal venous puncture, each access technique carries a unique set of risks and benefits. Thus, knowledge of these assistive techniques will add to the resources available to the surgeon when planning and subsequently performing a TIPS and, ultimately, increase the likelihood of a safe and successful procedure.

摘要

经颈静脉肝内门体分流术（TIPS）是介入放射学中最具挑战性的手术之一。肝内和门静脉解剖结构可能高度可变，而即使对于经验丰富的外科医生来说，进入门静脉也非常困难，这是 TIPS 中最关键的步骤。虽然有多种技术可以实现门静脉穿刺，但每种进入技术都有其独特的风险和益处。因此，当规划和随后进行 TIPS 时，了解这些辅助技术将增加外科医生可用的资源，最终增加安全和成功手术的可能性。

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本文引用的文献

1
Technical and Medium-Term Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt with Fluoroscopy and Additional Trans-abdominal Ultrasound Guidance.经颈静脉肝内门体分流术在透视及额外经腹超声引导下的技术及中期临床结果
Indian J Radiol Imaging. 2021 Nov 30;31(4):858-866. doi: 10.1055/s-0041-1735928. eCollection 2021 Oct.
2
Intracardiac Echocardiography-Guided TIPS: A Primer for New Operators.心腔内超声心动图引导下的经颈静脉肝内门体分流术：新手入门指南。
Semin Intervent Radiol. 2020 Oct;37(4):405-413. doi: 10.1055/s-0040-1715875. Epub 2020 Oct 1.
3
Ultrasound-Guided Portal Vein Access and Percutaneous Wire Placement in the Portal Vein Are Associated With Shorter Procedure Times and Lower Radiation Doses During TIPS Placement.
超声引导门静脉入路和经皮导丝置入与 TIPS 置管过程中的更短手术时间和更低辐射剂量相关。
AJR Am J Roentgenol. 2021 May;216(5):1291-1299. doi: 10.2214/AJR.20.23846. Epub 2020 Jul 29.
4
Transjugular intrahepatic portosystemic shunt placement: portal vein puncture guided by 3D/2D image registration of contrast-enhanced multi-detector computed tomography and fluoroscopy.经颈静脉肝内门体分流术置管：基于对比增强多排螺旋计算机断层扫描与荧光透视的三维/二维图像配准引导门静脉穿刺
Abdom Radiol (NY). 2020 Nov;45(11):3934-3943. doi: 10.1007/s00261-020-02589-1.
5
Transsplenic portal vein recanalization and direct intrahepatic portosystemic shunt placement to optimize liver transplantation.经脾门静脉再通及直接肝内门体分流术以优化肝移植
CVIR Endovasc. 2020 Jan 8;3(1):5. doi: 10.1186/s42155-019-0096-7.
6
Utility of Intravascular US-Guided Portal Vein Access during Transjugular Intrahepatic Portosystemic Shunt Creation: Retrospective Comparison with Conventional Technique in 109 Patients.经颈静脉肝内门体分流术创建过程中血管内超声引导门静脉穿刺的效用：109例患者与传统技术的回顾性比较
J Vasc Interv Radiol. 2016 Aug;27(8):1154-9. doi: 10.1016/j.jvir.2016.05.010. Epub 2016 Jun 28.
7
Comprehensive review of TIPS technical complications and how to avoid them.经颈静脉肝内门体分流术技术并发症的全面综述及如何预防。
AJR Am J Roentgenol. 2011 Mar;196(3):675-85. doi: 10.2214/AJR.10.4819.
8
Wedged hepatic venography for targeting the portal vein during TIPS: comparison of carbon dioxide and iodinated contrast agents.经颈静脉肝内门体分流术（TIPS）期间用于靶向门静脉的楔形肝静脉造影：二氧化碳与碘化造影剂的比较
Cardiovasc Intervent Radiol. 2002 May-Jun;25(3):171-5. doi: 10.1007/s00270-001-0096-5. Epub 2002 Feb 25.
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Transmesenteric-transfemoral method of intrahepatic portosystemic shunt placement with minilaparotomy.经肠系膜-经股动脉途径行小切口肝内门体分流术
J Vasc Interv Radiol. 1996 Jul-Aug;7(4):499-506. doi: 10.1016/s1051-0443(96)70790-x.
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Inadvertent arteriovenous stenting during transjugular intrahepatic portosystemic shunt procedure and the importance of hepatic artery perfusion.经颈静脉肝内门体分流术期间的意外动静脉支架置入及肝动脉灌注的重要性。
Cardiovasc Intervent Radiol. 1995 May-Jun;18(3):192-5. doi: 10.1007/BF00204150.