Sujanyal Saurabh Ashok, Shah Priyansh Parag, Willis Joseph Gartrell, El Khudari Husameddin, Varma Rakesh K
Division of Interventional Radiology, University of Alabama, USA.
Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, USA.
Radiol Case Rep. 2023 Sep 15;18(11):4172-4175. doi: 10.1016/j.radcr.2023.08.067. eCollection 2023 Nov.
Sharp recanalization for short-segment intravascular occlusion, using an endovascular route, has been described for inferior vena cava (IVC) occlusion. Often, the technical challenge to the endovascular management of Budd-Chiari syndrome (BCS) is the recanalization of the occluded hepatic vein or suprahepatic IVC. Presented here, the challenge was the level of occlusion of the suprahepatic IVC, with the resultant separation of both the patent IVC segments in a horizontal plane, making it technically challenging for sharp recanalization. We describe the use of percutaneous transhepatic access into the suprahepatic IVC via the middle hepatic vein under ultrasound guidance with eventual sharp recanalization of the occluded segment of the IVC, in a woman with BCS. This novel approach has not been described in the literature and can serve as an important addition to guide complex suprahepatic IVC recanalization.
对于下腔静脉（IVC）闭塞，已报道采用血管内途径对短节段血管内闭塞进行锐性再通。布加综合征（BCS）血管内治疗的技术挑战通常在于闭塞的肝静脉或肝上段IVC的再通。在此呈现的病例中，挑战在于肝上段IVC的闭塞水平，导致两个通畅的IVC节段在水平面上分离，这使得锐性再通在技术上具有挑战性。我们描述了在一名BCS女性患者中，在超声引导下经皮经肝通过肝中静脉进入肝上段IVC，最终对IVC闭塞段进行锐性再通的过程。这种新方法在文献中尚未有描述，可作为指导复杂的肝上段IVC再通的重要补充。
