复杂类型布-加综合征的介入治疗.ppt
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1、复杂类型布-加综合征的介入治疗Interventional Therapy of complex Budd-Chiari Syndrome,华中科技大学同济医学院附属协和医院介入放射科 张泽富,Interventional Radiology Department of Wuhan Union Hospital,Interventional Radiology Department of Wuhan Union Hospital,Part 1: overview,General definition Classification Pathological change Clinical man
2、ifestation Therapy .inverventional therapy is the first choice.,Interventional Radiology Department of Wuhan Union Hospital,Part 2: complex BCS,IVC . long segment occlusion . combining with thrombosis HV . segement occlusion . widespread occlusion Occlusion of HV & IVC,Interventional Radiology Depar
3、tment of Wuhan Union Hospital,Part 3: therapy & cases report,Interventional Radiology Department of Wuhan Union Hospital,IVC :long segement occlusion,Anatomy of IVC :pre-operation Angiography: two-way & multiple directions Puncture:resisting force & directions Track of guide wire Dilatation Endovasc
4、ular stent,Interventional Radiology Department of Wuhan Union Hospital,Figure 1. (a,b) A-P and LP angiography show the occlusion segment length is 8.2cm. (c,d) Using TIPS puncture needle reconstrcuted the occlusion segment.,a,b,c,d,Interventional Radiology Department of Wuhan Union Hospital,Figure 1
5、. The same patient. Using balloon dilated the occlusion segment and release Z-shape ES in IVC (eh).,e,f,g,h,Interventional Radiology Department of Wuhan Union Hospital,IVC: occlusion & thrombosis,D.D. of thrombus: per-operation Fresh thrombus:thrombolysis &suction &/. micro-caliber puncture Organize
6、d thrombus: mini-caliber puncture & ES & dilatation Thrombolysis & anticoagulation: postoperation,Interventional Radiology Department of Wuhan Union Hospital,Figure 2. Angiography of IVC shows the giant filling defect in IVC (a) and contrast medium contaminated the thrombus(b). Using UK injection fr
7、om the catheter two days later ,there is no sign of thrombus(c) and puncture the occlusion segment successfully(d).,a,b,c,d,Interventional Radiology Department of Wuhan Union Hospital,Figure 3. The images of MRI show the long segment organization thrombus in IVC(b, arrow head).,a,b,Interventional Ra
8、diology Department of Wuhan Union Hospital,Figure 4. (a,b) Angiography shows long segment occlusion and the irregular filling defect in IVC, which reachs the level of left renal vein outlet(arrow head). Puncture the occlusion and dilated it with balloon(c,d).,a,b,c,d,Interventional Radiology Departm
9、ent of Wuhan Union Hospital,e,f,g,h,Figure 4. (e,f) Using a bigger balloon dilated the occlusion segment and release Z-shape ES to fix the thrombus on the wall of IVC.,Interventional Radiology Department of Wuhan Union Hospital,HV:segement occlusion,Clinical manifestation:aggravated、 serious、 ascits
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- 关 键 词:
- 复杂 类型 综合征 介入 治疗
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