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Objective To investigate the selection and effectiveness of interventional treatment for different types of Budd-Chiari syndrome (BCS). Methods A total of 138 cases of BCS were divided into 4 types (type Ⅰ, membranous stenosis and obstruction of the inferior vena cava; type Ⅱ, segmental stenosis of the inferior vena cava; type Ⅲ, segmental obstruction of the inferior vena cava; type Ⅳ, patent inferior vena cava) and 9 subtypes according to results of angiography of the hepatic vein or the inferior vena cava. Therapeutic methods included percutaneous transluminal angioplasty (PTA) of the inferior vena cava and stent placement by way of the femoral vein, right cervical vein or subclavian vein, and PTA of the hepatic vein by way of the transhepatic approach, right cervical vein or inferior vena cava. Results The success rate was 100% (83/83) in type Ⅰ patients, 75.0% (9/12) in type Ⅱ patients, 81.6% (31/38) in type Ⅲ patients, and 60% (3/5) in type Ⅳ patients. One patient died (0.7%, 1/138). Complications occurred in 4 patients (2.9%, 4/138), including 2 cases of pericardial injury, 1 case of stent detachment, and 1 case of hepatic hemorrhage. Follow-up observations in 126 successful cases for 3~96 months (mean, 26 months) showed 8 recurrent cases, 2 of which expired, and 2 fatal cases because of hepatocarcinoma. Conclusions Interventional therapy, as a simple, safe and effective minimally invasive method, is the first choice for the treatment of BCS.
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Purpose:To study the clinical value of percutaneous placement of biliary stents tbr treatment of malignant biliary obstruction.Materials and methods:A total of 58 stents were placed pereutaneously in 53 patients for palliative of malignant biliary obstruction. Results:The success rate of stent implantation was 98.1%(52/53).The difference between post-and pre-operation in the serum total bilirubin level of 52 patients was 182?67 ? mol/L,P
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Objective To discuss the treatment of superior mesenteric arterial thrombo-embolism through superior mesenteric arterial angiography and transcatheterizing thrombolysis. Methods After diagnosis of superior mesenteric arterial thrombo-embolism through percutaneous transluminal angiography, the embolism was cleared out and then the inner tip of catheter was implanted within embolus for slow continuously thrombolysis with the outer tip of catheter connected to the infusion pump. Result Four cases succeeded with thrombolysis; 3 cases were performed with partial small intestinal excision with necrosis. Two cases healed. One case died of heart failure postoperatively and another case died of massive digestive tract hemorrhage. Conclusions Angiography can help to confirm the position of superior mesentery arterial thrombosis and the extent of intestinal ischemia. Early intrathrombus catheterization for clear out and thrombolysis can obtain satifactory prognosis.