经皮经肝门静脉介入术后使用明胶海绵进行栓塞。

IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Acta radiologica Pub Date : 2024-09-01 Epub Date: 2024-08-28 DOI:10.1177/02841851241273938
Eisuke Shibata, Hidemasa Takao, Osamu Abe
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引用次数: 0

摘要

背景:经皮经肝门静脉介入术后穿刺道出血可能危及生命。迄今为止,有关经皮经肝门静脉介入术后使用明胶海绵条进行穿刺道栓塞的研究仅针对少数患者,或非连续性患者,或鞘管直径相对较小的儿科患者。目的:评估经皮经肝门静脉入路后使用明胶海绵条进行穿刺道栓塞的安全性和有效性。材料和方法:2017 年 9 月至 2024 年 2 月间,连续性患者 100 例(61 名男性,39 名女性;鞘管直径相对较小的儿科患者):2017年9月至2024年2月期间,100名连续患者(61名男性,39名女性;平均年龄=53±15岁)使用经皮经肝方法接受了共计105次门静脉介入治疗。所有手术均使用明胶海绵条进行门静脉栓塞以切除 6-8 Fr 的鞘管,其中包括 71 例肝大部切除术前的门静脉栓塞、27 例肝移植后的门静脉球囊静脉成形术或支架置入术以及 7 例其他介入手术:结果:使用明胶海绵条进行门静脉栓塞术后未发生出血。3例肝移植术后手术和1例因血小板减少引起的门静脉狭窄手术中发现轻微的门静脉血栓形成。在所有手术中,血栓都发生在穿刺的门静脉分支。所有患者的血栓形成都与临床无关,而且很难区分血栓形成是由鞘管置入还是明胶海绵插入造成的:结论:经皮经肝门静脉介入术后使用明胶海绵条进行穿刺道栓塞是一种安全可行的预防穿刺道出血的方法。
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Tract embolization with gelatin sponge after percutaneous transhepatic portal vein intervention.

Background: Bleeding from the puncture tract after percutaneous transhepatic portal vein intervention can become life-threatening. To date, studies about tract embolization with gelatin sponge after percutaneous transhepatic portal vein intervention are only with small numbers of patients, or non-consecutive or pediatric patients with a relatively small sheath in diameter.

Purpose: To evaluate the safety and efficacy of tract embolization with gelatin sponge strips after percutaneous transhepatic poral vein access.

Material and methods: Between September 2017 and February 2024, 100 consecutive patients (61 men, 39 women; mean age = 53 ± 15 years) underwent a total of 105 portal vein interventions using a percutaneous transhepatic approach. Tract embolization for the removal of 6-8 Fr sheath was performed using gelatin sponge strips in all procedures, including 71 portal vein embolization before major hepatectomy, 27 portal balloon venoplasty or stent placement after liver transplantation, and seven other interventions.

Results: No bleeding occurred after tract embolization with gelatin sponge strips. Minor portal vein thrombosis was detected in three procedures after liver transplantation and in one procedure for portal vein stenosis caused by essential thrombocytopenia. Thrombosis occurred in the punctured portal vein branch in all procedures. Thrombosis was not clinically relevant in any patient, and it was difficult to differentiate whether thrombosis was caused by sheath placement or the inserted gelatin sponge.

Conclusion: Tract embolization with gelatin sponge strips after percutaneous transhepatic portal vein intervention is a safe and feasible method for preventing hemorrhage from the puncture tract.

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来源期刊
Acta radiologica
Acta radiologica 医学-核医学
CiteScore
2.70
自引率
0.00%
发文量
170
审稿时长
3-8 weeks
期刊介绍: Acta Radiologica publishes articles on all aspects of radiology, from clinical radiology to experimental work. It is known for articles based on experimental work and contrast media research, giving priority to scientific original papers. The distinguished international editorial board also invite review articles, short communications and technical and instrumental notes.
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