Dolmatch B L, Cooper B S, Chang P P, Gray R J, Horton K M
Department of Radiology, Washington Hospital Center, Washington, DC 20010, USA.
Cardiovasc Intervent Radiol. 1995 Jan-Feb;18(1):46-9. doi: 10.1007/BF02807356.
A 33-year-old woman with Budd-Chiari syndrome for 9 years presented with worsening right upper quadrant pain and progressive liver dysfunction. Hepatic venography demonstrated hepatic vein occlusions, without significant IVC obstruction. Attempts at stenting a stenotic middle hepatic vein were unsuccessful. Transjugular access, however, allowed puncture from the stump of the right hepatic vein into the engorged right intrahepatic vein that had been demonstrated by retrograde hepatic venography. Two Palmaz stents were used to form the veno-venous reanastomosis. Initial success was documented angiographically and by pressure measurements before and after shunting. Followup at 7 and 16 months confirmed patency of the anastomosis without intimal hyperplasia. The patient noted near-complete resolution of her pain, and her liver function stabilized.
一名患有布加综合征9年的33岁女性，出现右上腹疼痛加重和进行性肝功能障碍。肝静脉造影显示肝静脉闭塞，下腔静脉无明显梗阻。对狭窄的肝中静脉进行支架置入术未成功。然而，经颈静脉途径允许从右肝静脉残端穿刺进入逆行肝静脉造影显示的扩张的右肝内静脉。使用两个帕尔马兹支架形成静脉-静脉再吻合术。血管造影和分流前后的压力测量记录了最初的成功。7个月和16个月的随访证实吻合口通畅，无内膜增生。患者指出疼痛几乎完全缓解，肝功能稳定。
