Vogel J, Görich J, Kramme E, Merkle E, Sokiranski R, Kern P, Brambs H J
Department of Radiology, University Clinic of Ulm, Germany.
Gut. 1996 Nov;39(5):762-4. doi: 10.1136/gut.39.5.762.
Infiltration of the hepatic veins in the alveolar echinococcosis can lead to the development of the Budd-Chiari syndrome. The medical and surgical treatment of this condition is generally unsatisfactory. The results of successful interventional treatment with percutaneous stent implantation in the hepatic veins are reported.
Using a transjugular approach, metal mesh stents (Boston Scientific, Medi-Tech Accuflex 8/60 mm) were placed in the median and left hepatic veins of a 53 year old woman. After the intervention, oral chemotherapy with albendazole (2 x 400 mg/day) was continued, but no anticoagulants were given.
Stent placement was performed without complications. The clinical picture improved rapidly: normalisation of portal blood flow was confirmed by Doppler ultrasound and there was improvement of liver function, reduction of oesophageal varices, and disappearance of ascites. A follow-up examination at 15 months showed no evidence of stent occlusion.
Treatment of portal hypertension in alveolar echinococcosis of the liver is problematic. In selected patients with portal hypertension secondary to hepatic vein stenoses but no cirrhosis, percutaneous stent placement in the hepatic veins represents a promising treatment alternative.
肝静脉受泡型包虫病浸润可导致布加综合征。这种疾病的内科及外科治疗总体效果欠佳。本文报道了经皮肝静脉支架植入术成功介入治疗的结果。
采用经颈静脉途径，将金属网状支架（波士顿科学公司，美迪泰克Accuflex 8/60毫米）置入一名53岁女性患者的肝中静脉和肝左静脉。介入治疗后，继续给予阿苯达唑口服化疗（2×400毫克/天），但未使用抗凝剂。
支架置入过程无并发症。临床症状迅速改善：多普勒超声证实门静脉血流恢复正常，肝功能改善，食管静脉曲张减轻，腹水消失。15个月的随访检查显示无支架闭塞迹象。
肝泡型包虫病门静脉高压的治疗存在问题。对于因肝静脉狭窄继发门静脉高压但无肝硬化的特定患者，经皮肝静脉支架置入术是一种有前景的治疗选择。
