[Analysis of the short-and medium-term curative effect of TIPS approach combined with AngioJet thrombus aspiration technology treatment in acute portal vein thrombosis]

Zhonghua Gan Zang Bing Za Zhi. 2021 Aug 20;29(8):754-758. doi: 10.3760/cma.j.cn501113-20200804-00435.
[Article in Chinese]

Abstract

Objective: To evaluate the short- and medium-term clinical efficacy of TIPS approach combined with AngioJet thrombus aspiration technology treatment in acute portal vein thrombosis. Methods: 63 cases with acute portal vein thrombosis treated in our center from May 2017 to July 2019 were studied retrospectively, including 49 males and 14 females, aged 35-61 (46 ± 5) years. TIPS approach (with/without) combined with Angiojet thrombus aspiration and gastroesophageal varices embolization was performed simultaneously according to the patient's condition. Regular follow-up for 3-33 (22 ± 3) months after surgery was used to observe the curative effect. Results: The technical success rate was 100%. Portal vein and superior mesenteric vein blood flow were returned to normal after the operation. Two cases of biliary tract injury were untreated. Simultaneously, two cases of intrahepatic arteriovenous fistula were treated with superselective arterial embolization. During the follow-up period, 47 cases (74.61%) had complete portal vein recanalization, 13 cases (20.63%) had partial recanalization, 3 cases (4.76%) had complete portal cavernoma, 7 cases (11.11%) had symptomatic hepatic encephalopathy, 1 case had received artificial liver treatment (1.59%), 1 case had peptic ulcer (11.11%), 6 cases (9.52%) had lost to follow-up, and there was no portal hypertension-related bleeding or death. Conclusion: TIPS approach combined with AngioJet thrombus aspiration technology is safe, effective and feasible in the treatment of acute portal vein thrombosis, and the short- and medium-term clinical effects are satisfactory.

目的: 评价经颈静脉肝内门体分流术途径联合AngioJet血栓抽吸技术治疗急性门静脉血栓的中短期临床疗效。 方法: 回顾性研究河南省介入治疗中心2017年5月至2019年7月期间收治的63例急性门静脉血栓患者资料,其中男性49例,女性14例,年龄35至61(46±5)岁,实施经颈静脉肝内门体分流术途径联合AngioJet血栓抽吸术,实施(或不实施)经颈静脉肝内门体分流术,以及根据患者病情同期实施(或不实施)胃底食管静脉曲张栓塞术。术后定期随访3至33(22±3)个月观察疗效。 结果: 技术成功率100%,术后门静脉及肠系膜上静脉血流恢复通畅,胆道损伤2例,未处理;肝内动静脉瘘2例,同期给予超选择动脉栓塞;随访期间,门静脉完全再通47例(74.61%),部分再通13例(20.63%),门静脉完全阻塞伴门静脉海绵样变3例(4.76%),症状性肝性脑病7例(11.11%),1例行人工肝治疗(1.59%),消化道溃疡1例(11.11%),失访6例(9.52%)。无门静脉高压相关性出血、病死等。 结论: 通过经颈静脉肝内门体分流术途径联合AngioJet血栓抽吸技术治疗急性门静脉血栓是安全、有效、可行的,中短期临床效果令人满意。.

Keywords: AngioJet; TIPS; acute portal vein thrombosis.

MeSH terms

  • Female
  • Humans
  • Male
  • Portal Vein / surgery
  • Portasystemic Shunt, Transjugular Intrahepatic*
  • Retrospective Studies
  • Technology
  • Thrombosis*
  • Treatment Outcome