经逆行途径进行的输入静脉栓塞术作为十二指肠静脉曲张出血的一种潜在治疗策略。
Afferent vein embolization via retrograde approach as a potential treatment strategy for bleeding duodenal varices.
作者信息
Jogo Atsushi, Yamamoto Akira, Kageyama Ken, Sasaki Fumi, Oura Tatsushi, Mitsuyama Yasuhito, Terayama Eisaku, Matsushita Kazuki, Asano Kazuo, Sakai Yuki, Ozaki Masanori, Harada Shohei, Murai Kazuki, Nakano Mariko, Sohgawa Etsuji, Kita Ryuichi, Kaminou Toshio, Miki Yukio
机构信息
Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
Department of Gastroenterology, Osaka, Japan.
出版信息
Radiol Case Rep. 2023 Sep 26;18(12):4327-4330. doi: 10.1016/j.radcr.2023.08.096. eCollection 2023 Dec.
The standard treatment for ruptured duodenal varices remains to be established. Emergency balloon-occluded retrograde transvenous obliteration is challenging in patients with bleeding because re-rupture of varices can occur due to increased pressure when using the retrograde approach. Herein, we describe a case in which a catheter was retrogradely advanced to the afferent vein beyond bleeding duodenal varices; however, the varices re-ruptured during coil embolization, and a part of the catheter was deviated into the intestinal tract. The rupture site was embolized by liquid embolic materials from the microcatheter. Embolization via retrograde approach needs to be carefully performed.
十二指肠静脉曲张破裂的标准治疗方法仍有待确立。对于出血患者，紧急球囊闭塞逆行经静脉闭塞术具有挑战性，因为采用逆行方法时，静脉曲张可能因压力增加而再次破裂。在此，我们描述了一例病例，其中一根导管逆行推进至出血的十二指肠静脉曲张的供血静脉；然而，在弹簧圈栓塞过程中静脉曲张再次破裂，导管的一部分偏离进入肠道。通过微导管用液体栓塞材料对破裂部位进行了栓塞。逆行栓塞方法需要谨慎操作。
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