ABSTRACT
Objective: To investigate the DSA manifestations of the portosystemic collateral vessels (PSCV) in the patients with decompensated cirrhotic portal hypertension (DCPH) and the feasibility of portovenography performed with catheterizing in the portal vein directly through TIPS. Methods: Totally 274 patients with DCPH who were treated with TIPS were enrolled and retrospectively analyzed. DSA was directly performed with catheterizing in the superior mesenteric vein and splenic vein through TIPS, respectively. DSA manifestations of PSCV were observed and described. And PSCV were classified based on the manifestations. Results: All 274 patients were successfully treated with portal vein angiography and TIPS, and no postoperative complications occurred. According to the origin, PSCV could be classified into four types, including branch of portal vein type (2.55% [7/274]), which were blood to hepatic and mainly by shunt; main portal vein type (23.36% [64/274]), which were blood leaving hepatic with large blood flow; tributaries of the portal vein type (12.77% [35/274]), which were blood leaving hepatic with various ways to systemic circulation; multi-sources type (61.31% [168/274]), which were supplied by multiple origins. Conclusion: Direct portovenography through TIPS is safe and feasible,which can display classification of PSCV, including branch of portal vein type, main portal vein type, tributaries of portal vein type and multi-sources type, all having different hemodynamic characteristics.
ABSTRACT
Objective To investigate the clinical applications of sandwich technique according to area calculation in endovascular aneurysm repair of patients with aorta and iliac artery lesions.Methods Six patients with aortoiliac artery disease confirmed by CT were treated using sandwich technique according to area calculation.The diameter of the main stent and two branches stents were chosen according to the area calculation.Technical success rate,patency of the stent graft and complications were observed.Results Technical success rate was 100％ (6/6),and no complications occurred in all the 6 patients.The clinical symptoms were significantly improved.Gutter endoleak was found in 1 patient 2 months after the procedure,and was managed by coil embolization successfully.No endoleak occurred in other patients during follow-up of 6-31 months.Conclusion For patients with special anatomy of aorta and iliac artery lesions,the application of area calculation in the sandwich technique provides a feasible approach in choosing the matching size of the main body stent and two side branches stents.