在 transcatheter 以后的征兆的 arterioportal 管的临床的结果动脉的 embolization

• 作者: Akihiro Nishie Hiroshi Honda Kousei Ishigami Masakazu Hirakawa Nobuhiro Fujita Yasuhiro Ushijima Yoshiki Asayama
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: Arterioportal FISTULA IATROGENIC PORTAL hypertension PORTAL THROMBOSIS TRANSCATHETER arterial EMBOLIZATION
• 年，卷（期）: 2013,（2）
• 页码范围: 33-40
• 页数: 8页
• 分类号: R575

摘要

AIM: To evaluate the complications and clinical outcomes of transcatheter arterial embolization (TAE) for symptoms related to severe arterioportal fistulas (APFs). METHODS: Six patients (3 males, 3 females; mean age, 63.8 years; age range, 60-71 years) with chronic liver disease and severe APFs due to percutaneous intrahepatic treatment (n=5) and portal vein (PV) tumor thrombosis of hepatocellular carcinoma (n=1) underwent TAE for symptoms related to severe APFs [refractory ascites (n=4), hemorrhoidal hemorrhage (n=1), and hepatic encephalopathy (n=1)]. Control of symptoms related to APFs and complications were evaluated during the follow-up period (range, 4-57 mo). RESULTS: In all patients, celiac angiography revealed immediate retrograde visualization of the main PV before TAE, indicating severe APF. Selective TAE for the hepatic arteries was performed using metallic coils (MC, n=4) and both MCs and n-butyl cyanoacrylate (n=2). Three patients underwent repeated TAEs for residual APFs and ascites. Four patients developed PV thrombosis after TAE. During the follow-up period after TAE, APF obliteration and symptomatic improvement were obtained in all patients. CONCLUSION: Although TAE for severe APFs may sometimes be complicated by PV thrombosis, TAE can be an effective treatment to improve clinical symptoms related to severe APFs.