Probst P, Rysavy J A, Amplatz K
AJR Am J Roentgenol. 1978 Sep;131(3):445-9. doi: 10.2214/ajr.131.3.445.
Splenoportography, a useful preoperative diagnostic procedure in patients with portal hypertension, has been largely discontinued because of the risk of hemorrhage. We have used both Ivalon and Gelfoam in particle and plug form to plug the needle tract after splenoportography. Initial studies were conducted on six dogs. Plugging of the needle tract by injection of suspensions of small Gelfoam or Ivalon particles resulted in intravasation of these particles into the splenic vein. This was demonstrated by radioactive tagging of particles and the direct collection of splenic blood during the intrasplenic injection. Plugging of the splenic needle tract with compressed Gelfoam caused immediate, complete cessation of bleeding in fully heparinized animals. Because of these experimental results, five humans with decreased platelet counts and severe portal hypertension underwent successful splenoportography without significant hemorrhage. At surgery, successful plugging of the needle tract by Gelfoam was confirmed.
脾门静脉造影术是门静脉高压患者术前一种有用的诊断方法，但由于有出血风险，目前已基本不再使用。我们使用了颗粒状和栓塞状的异丁烯酸聚乙烯酯泡沫塑料（Ivalon）和明胶海绵来封堵脾门静脉造影术后的针道。最初的研究是在6只狗身上进行的。通过注射小颗粒明胶海绵或Ivalon悬浮液来封堵针道，结果导致这些颗粒进入脾静脉。这通过颗粒的放射性标记以及脾内注射期间直接采集脾血得到了证实。用压缩明胶海绵封堵脾针道可使完全肝素化的动物立即、完全止血。由于这些实验结果，5名血小板计数减少且患有严重门静脉高压的患者成功接受了脾门静脉造影术，且无明显出血。在手术中，证实明胶海绵成功封堵了针道。
