经颈静脉肝内门体分流术创建过程中门静脉穿刺的先进技术。
Advanced Techniques for Accessing the Portal Vein during Transjugular Intrahepatic Portosystemic Shunt Creation.
作者信息
Sinha Ishan, Goldman Daryl T, Patel Rahul S, Nowakowski Francis S
机构信息
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York.
出版信息
Semin Intervent Radiol. 2023 May 4;40(1):79-86. doi: 10.1055/s-0043-1767688. eCollection 2023 Feb.
Abstract
Transjugular portosystemic shunt (TIPS) placement is a widely accepted method for reducing portal pressures in conditions including symptomatic varices, refractory ascites, hepatic hydrothorax, portomesenteric thrombosis, and Budd-Chiari syndrome. The traditional method for performing TIPS involves "blind" access into a portal vein branch from a hepatic vein, typically right portal vein to right hepatic vein, using preoperative imaging and intraoperative wedged portography for guidance. However, standard access technique may not always be feasible due to occluded portal or hepatic veins, distorted anatomy, or prior TIPS. In this article we discuss alternative techniques for accessing the portal vein for TIPS placement when standard methods are not sufficient.
摘要
经颈静脉肝内门体分流术（TIPS）置入是一种广泛接受的降低门静脉压力的方法，适用于包括有症状的静脉曲张、顽固性腹水、肝性胸水、门静脉肠系膜血栓形成和布加综合征等情况。传统的TIPS操作方法是在术前成像和术中楔形门静脉造影的引导下，从肝静脉“盲目”进入门静脉分支，通常是从右门静脉到右肝静脉。然而，由于门静脉或肝静脉闭塞、解剖结构扭曲或既往已行TIPS，标准的入路技术可能并不总是可行的。在本文中，我们讨论了在标准方法不足时，用于TIPS置入的门静脉入路的替代技术。
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