Percutaneous treatment of venous outflow obstruction in pediatric liver transplants.
Percutaneous treatment of venous outflow obstruction in pediatric liver transplants.
复制标题
经皮治疗小儿肝移植中静脉流出道阻塞。
DOI：
10.1097/01.rvi.0000241540.31081.52
复制
发表时间：
2006
期刊：
影响因子：
--
通讯作者：
J. Rosenblum
中科院分区：
文献类型：
--
作者：
J. Lorenz;T. V. Van Ha;B. Funaki;M. Millis;J. Leef;A. Bennett;J. Rosenblum
目的
评价经皮扩张治疗小儿肝移植患者静脉流出道受损的有效性和安全性。
材料和方法
回顾了16名连续儿童（年龄11天至17.8岁，平均7.2 ± 5.8岁）在肝移植术后8年内35次扩张受损静脉流出的记录。患者在临床上表现出肝静脉或下腔静脉吻合口阻塞的体征或症状和/或异常的非侵入性成像结果，并主要转诊至介入放射科进行治疗。无一例被排除。计算技术和临床成功率。静脉成形术后，静脉造影分辨率不完全或压力梯度超过5 mm Hg的患者接受支架治疗。在研究期间，7例死亡或因与静脉流出道阻塞无关的原因需要重复移植。计算了在儿科肝病诊所接受充分随访的所有其他患者的通畅率。
结果
静脉成形术（12/16）和支架置入术（3/16）的技术成功率为94%（15/16），临床成功率为81%（13/16）。发生了一个轻微的并发症：短暂的缺氧发作。3个月时一期通畅率为72.7%（8/11），6个月时为60%（6/10），12个月时为55.6%（5/9），18个月时为50%（4/8），36个月时为50%（36）。3个月时的一期辅助通畅率和二期通畅率为90.9%（10/11），6个月时为90%（9/10），12个月时为88.9%（8/9），18个月时为87.5%（7/8），36个月时为83.3%（5/6）。
结论
小儿肝移植术后，经皮扩张受损静脉流出道可获得良好的技术和临床成功率。长期通畅可能需要重复干预。
PURPOSE
To evaluate the efficacy and safety of percutaneous dilation in the treatment of impaired venous outflow in pediatric patients with liver transplants.
MATERIALS AND METHODS
Review was undertaken of the records of 35 procedures to dilate impaired venous outflow in 16 consecutive children (aged 11 days to 17.8 years; mean, 7.2 +/- 5.8 y) after liver transplantation over a period of 8 years. Patients presented clinically with signs or symptoms of obstruction of the hepatic venous or inferior vena cava anastomosis and/or abnormal noninvasive imaging findings and were referred primarily to the interventional radiology department for treatment. None were excluded. Technical and clinical success rates were calculated. After venoplasty, patients with incomplete venographic resolution or pressure gradients exceeding 5 mm Hg were treated with stents. Seven died or required repeat transplantation during the study period for reasons unrelated to venous outflow obstruction. Patency rates were calculated for all other patients with sufficient follow-up in the pediatric hepatology clinic.
RESULTS
The combined technical success rate for venoplasty (12 of 16) and stent placement (three of 16) was 94% (15 of 16), and the clinical success rate was 81% (13 of 16). One minor complication occurred: a transient hypoxic episode. Primary patency rates were 72.7% (eight of 11) at 3 months, 60% (six of 10) at 6 months, 55.6% (five of nine) at 12 months, 50% (four of eight) at 18 months, and 50% (three of six) at 36 months. Primary assisted and secondary patency rates were 90.9% (10 of 11) at 3 months, 90% (nine of 10) at 6 months, 88.9% (eight of nine) at 12 months, 87.5% (seven of eight) at 18 months, and 83.3% (five of six) at 36 months.
CONCLUSIONS
Excellent technical and clinical success rates can be achieved with percutaneous dilation of impaired venous outflow after pediatric liver transplantation. Long-term patency may require repeated interventions.
（第二作者），经皮肝穿刺静脉成形术治疗活体肝移植后肝静脉流出道阻塞的结果。
DOI：
--
发表时间：
2006
期刊：
Radiology 239
影响因子：
--
作者：
Kubo T;Shibata T;et al.
通讯作者：
et al.
影响因子：
9
作者：
TANAKA, K;UEMOTO, S;OZAWA, K
通讯作者：
OZAWA, K