[1]赵 丹,梁 斌,张利捷,等.单导丝门静脉定位技术在经颈静脉肝内门体分流术中的应用[J].介入放射学杂志,2019,28(09):833-836.
 ZHAO Dan,LIANG Bin,ZHANG Lijie,et al.Portal vein localization technique with a single guidewire during TIPS[J].journal interventional radiology,2019,28(09):833-836.
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单导丝门静脉定位技术在经颈静脉肝内门体分流术中的应用()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
28
期数:
2019年09期
页码:
833-836
栏目:
血管介入
出版日期:
2019-09-25

文章信息/Info

Title:
Portal vein localization technique with a single guidewire during TIPS
作者:
赵 丹 梁 斌 张利捷 潘 峰 周国锋 郑传胜
Author(s):
ZHAO Dan LIANG Bin ZHANG Lijie PAN Feng ZHOU Guofeng ZHENG Chuansheng.
Department of Radiology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430022, China
关键词:
【关键词】 门体分流术 经颈静脉肝内 高血压 门静脉 穿刺术
文献标志码:
A
摘要:
【摘要】 目的 探讨单导丝门静脉定位技术辅助经颈静脉肝内门体分流术(TIPS)中肝内门静脉穿刺的有效性和安全性。 方法 连续收集2017年1月至2018年8月因肝硬化门静脉高压症接受单导丝门静脉定位辅助TIPS治疗的12例患者临床资料。术前通过门静脉CTV评估门静脉解剖并预先选定肝内门静脉穿刺点。术中在彩色超声导引下采用21 G Chiba针经皮经肝穿刺肝内门静脉分支,引入0.014英寸导丝并将其远端置入脾静脉,再以导丝为靶向经肝静脉穿刺门静脉左支或右支主干,穿刺成功后完成后续TIPS操作;术毕拔除门静脉定位导丝,无需封堵穿刺道。观察评估门静脉穿刺次数、穿刺成功率及穿刺相关并发症。 结果 12例TIPS患者肝内门静脉穿刺均获成功。其中8例经Ⅲ段门静脉分支入路放置细导丝导向经肝静脉穿刺门静脉左支主干建立分流道,4例经Ⅷ段门静脉分支入路放置细导丝导向经肝静脉穿刺门静脉右支主干建立分流道。平均穿刺次数为(1.25±0.45)次(1~2次),术后患者均未出现门静脉穿刺相关并发症。 结论 采用单导丝定位门静脉辅助TIPS术中门静脉穿刺技术操作简便、安全有效,适用于TIPS分流道穿刺高风险患者。

参考文献/References:

[1] Owen AR, Stanley AJ, Vijayananthan A, et al. The transjugular intrahepatic portosystemic shunt(TIPS)[J]. Clin Radiol, 2009, 64: 664-674.
[2] Richter GM, Noldge G, Brado M, et al. TIPSS: 10 years of clinical experience[J]. Rofo, 1998, 168: 307-315.
[3] Haskal ZJ, Martin L, Cardella JF, et al. Quality improvement guidelines for transjugular intrahepatic portosystemic shunts[J]. J Vasc Interv Radiol, 2001, 12: 131-136.
[4] Krajina A, Lojik M, Chovanec V, et al. Wedged hepatic venography for targeting the portal vein during TIPS: comparison of carbon dioxide and iodinated contrast agents[J]. Cardiovasc Intervent Radiol, 2002, 25: 171-175.
[5] Farsad K, Kaufman JA. Novel image guidance techniques for portal vein targeting during transjugular intrahepatic portosystemic shunt creation[J]. Tech Vasc Interv Radiol, 2016, 19: 10-20.
[6] Chen Y, Ye P, Li Y, et al. Percutaneous transhepatic balloon-assisted transjugular intrahepatic portosystemic shunt for chronic, totally occluded, portal vein thrombosis with symptomatic portal hypertension: procedure technique, safety, and clinical applications[J]. Eur Radiol, 2015, 25: 3431-3437.
[7] 汤善宏, 秦建平, 束庆飞,等. TIPS 术中引导门静脉分支穿刺方法[J]. 介入放射学杂志, 2014, 23: 640-643.

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[1]杨建勇,刘子江.经颈静脉肝内门体静脉支撑架分流术[J].介入放射学杂志,1994,(03):165.
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备注/Memo

备注/Memo:
(收稿日期:2018-10-31)
(本文编辑:边 佶)
更新日期/Last Update: 2019-09-24