覆膜支架弹性回直致TIPS分流道失功能原因分析
[Abstract]:Objective to investigate the causes of (TIPS) shunt dysfunction after intrahepatic portosystemic shunt through jugular vein induced by elastic return of covered stent. Methods the data of 31 patients with interventional shunt repair from January 2008 to December 2015 were retrospectively analyzed. According to the DSA imaging data of two interventional operations, 31 patients were divided into elastic return group (group A = 16 cases). 37 cases of TIPS were followed up for more than 2 years and shunt patency was established as control group (group C). The clinical data of each group were compared and analyzed. The angle of hepatic vein end, portal vein end and hepatic parenchymal shunt pathway were recorded as 伪 and 尾 angles respectively. Results the primary patency time was (18.9 卤14.6) months in group A, (4.0 卤4.8) months in group B, and (30.6 卤5.9) months in group C (P 0.001). There was no significant difference in sex, age, TIPS indication and etiology of liver cirrhosis among groups. There was no significant difference in 伪 angle between groups A (167.2 掳卤8.9 掳), B (164.5 掳卤21.3 掳) and C (175.5 掳卤8.1 掳). In group B, 67% of the covered stents were covered to the opening of hepatic vein, and 92% of the covered stents of group C were covered to the opening of hepatic veins. The difference was statistically significant (P0.001). Logistic regression analysis showed 尾 angle (OR=0.929,P=0.010). The coverage of the covered stent to the hepatic vein opening (OR=0.100,P=0.002) was related to the dysfunction of the shunt of TIPS. Conclusion Elastic recanalization of covered stent is the main factor of long-term shunt dysfunction after TIPS. The great bending angle of portal vein end and short length of hepatic vein end of covered stent are the important reasons for shunt dysfunction caused by elastic return of covered stent.
【作者单位】: 南方医科大学南方医院介入科;
【分类号】:R575.2
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