ABSTRACT
The results of endovascular diagnosis and transcatheter surgery in 113 patients with various forms and stages of portal hypertension are analysed. A total of 761 diagnostic and 194 therapeutic radiologically-guided endovascular interventions were carried out. Purposeful study of the arteriovenous angioarchitectonics in the hepato-lienal system, the character and degree of disorders of the portal-hepatic hemodynamics, and the peculiar features of collateral circulation before and after various radiologically-guided interventions allowed the authors to elaborate an orderly system of stage-by-stage endovascular treatment of patients suffering from portal hypertension.
Subject(s)
Embolization, Therapeutic/methods , Hepatic Artery/pathology , Hypertension, Portal/diagnosis , Liver/blood supply , Portal System/pathology , Adult , Catheterization, Peripheral , Humans , Hypertension, Portal/therapy , Middle AgedABSTRACT
Combined assessment of changes in renal angio-architectonics and hemodynamics demonstrated significant disorders of those in cases of Leriche syndrome and vasorenal hypertension. These changes should not be neglected, if an adequate assessment of renal circulation and metabolism is to be made. It is in this way only that valid data on renal function can be obtained, an essential prerequisite for rational indications for the reconstruction of terminal abdominal aorta and renal arteries as well as the choice of an adequate scope and steps of intervention. In addition immediate and long-term prognosis of the course of the disease and the efficiency of intervention can thus be made.
Subject(s)
Hypertension, Renovascular/physiopathology , Ischemia/etiology , Kidney/blood supply , Leriche Syndrome/physiopathology , Renal Circulation , Hemodynamics , Humans , Hypertension, Renovascular/complications , Leriche Syndrome/complicationsABSTRACT
The article deals with the results of treatment of 27 patients with profuse esophageal hemorrhage in portal hypertension. Sixteen patients were treated by roentgen-guided endovascular surgery, namely, transhepatic transportal embolization of varicose veins of the esophagus and stomach. In view of the peculiarities of blood drainage and for the prevention of recurrent bleeding, seven patients were subjected to additional manipulations: embolization of the splenic artery (4) and the left gastric artery (3). Despite reliable arrest of bleeding, 3 patients died in the first 2-3 days from progressive hepatorenal failure. Only one patient had recurrent bleeding in the late-term period. The authors believe transhepatic transportal embolization of the gastroesophageal veins at the peak of hemorrhage to be a hardly injurious and effective method for its arrest.
Subject(s)
Embolization, Therapeutic/methods , Esophageal and Gastric Varices/therapy , Gastrointestinal Hemorrhage/therapy , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
The article deals with results of treatment of 82 patients with portal hypertension. Endovascular embolization of the splenic artery was used in 49 patients; percutaneous transhepatic embolization of esophageal veins--in 24 patients. Positive results were obtained in chronic occlusion of the splenic artery and in a stepwise use of endovascular interventions. Emergent embolization of esophageal varices is recommended in patients with esophageal hemorrhage.
