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Objective To explore the selection of reasonable interventional treatment to portal hypertension under different conditions.Methods The data of 76 patients with portal hypertension and interventional treatment from 1997 to 2002 were retrospectively analyzed. 26 patients were treated with transjugular intrahepatic porto-systemic stent shunt (TIPSS). Of these 26 patients, 11 patients suffered from hemorrhage after surgery treatment by devascularization, 6 patients with hemorrhage after stomach mirror treatment, and 9 patients with ineffective medicine treatment. 50 patients were treated with percutaneous transhepatic variceal embolization (PTVE) combined with partial splenic embolization (PSE), and they all showed inefficacy by medicine treatment. Free portal pressure (FPP) in pre- and post-treatment was measured in all 76 cases. The hepatic volume was measured by spiral-CT before and one year after the treatment.Results In TIPSS group, FPP was reduced from (3.85?0.42) kPa to (3.09?0.44) kPa (( t= 3.682, P
RESUMO
Objective To evaluate the clinical feasibility and validity of interventional therapy in thrombo angitis obliterans. Methods 13 patients with thrombo angitis obliterans were treated with percutaneous left subclavian artery port catheter system implantation. The catheter external iliac artery with perfusion of prostaglandin E1 (PGE1) 100Ug, urokinase (UK) 200,000U and mailuoning 20 ml every day. Each treatment lasted for 7 10 days. Results 13 patients with angiographic demonstration showed occlusions of 1 case in the middle segment of superficial femoral artery, 9 cases of complete occlusion in popliteal artery and same for 3 cases in anterior tibial artery, the end of the peroneal artery and posterior tibial artery. After treatment, 3 patients had to undergo amputation due to gangrene in foot and 10 patients with no gangrene showed skin temperature rising up in the lower limb. Intermittent claudication and rest pain were relieved obviously accompanied by increasing step distance over 500 m with the Fontain grade improvement of twice at least. Follow up angiography one year later showed large quantity of vasculogenesis in the lower limb. Conclusion The treatment of trans port catheter system is excellent and practical for improving the clinical status of patients with thrombo angitis obliterans.