复杂类型布-加综合征的介入治疗

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1、复杂类型布-加综合征的介入治疗InterventionalTherapyofcomplexBudd-ChiariSyndrome华中科技大学同济医学院附属协和医院介入放射科张泽富InterventionalRadiologyDepartmentofWuhanUnionHospitalInterventionalRadiologyDepartmentofWuhanUnionHospitalPart1：overviewGeneraldefinitionClassificationPathologicalchangeClini

2、calmanifestationTherapy.inverventionaltherapyisthefirstchoice.InterventionalRadiologyDepartmentofWuhanUnionHospitalPart2：complexBCSIVC.longsegmentocclusion.combiningwiththrombosisHV.segementocclusion.widespreadocclusionOcclusionofHV&IVCInterventionalRadiologyDepa

3、rtmentofWuhanUnionHospitalPart3：therapy&casesreportInterventionalRadiologyDepartmentofWuhanUnionHospitalIVC：longsegementocclusionAnatomyofIVC：pre-operationAngiography：two-way&multipledirectionsPuncture：resistingforce&directionsTrackofguidewireDilatationEndovascul

4、arstentInterventionalRadiologyDepartmentofWuhanUnionHospitalFigure1.(a,b)A-PandLPangiographyshowtheocclusionsegmentlengthis8.2cm.(c,d)UsingTIPSpunctureneedlereconstrcutedtheocclusionsegment.abcdInterventionalRadiologyDepartmentofWuhanUnionHospitalFigure1.Thesamep

5、atient.UsingballoondilatedtheocclusionsegmentandreleaseZ-shapeESinIVC(e～h).efghInterventionalRadiologyDepartmentofWuhanUnionHospitalIVC：occlusion&thrombosisD.D.ofthrombus:per-operationFreshthrombus：thrombolysis&suction&/.micro-caliberpunctureOrganizedthrombus：min

6、i-caliberpuncture&ES&dilatationThrombolysis&anticoagulation:postoperationInterventionalRadiologyDepartmentofWuhanUnionHospitalFigure2.AngiographyofIVCshowsthegiantfillingdefectinIVC(a)andcontrastmediumcontaminatedthethrombus(b).UsingUKinjectionfromthecathetertwod

7、ayslater,thereisnosignofthrombus(c)andpuncturetheocclusionsegmentsuccessfully（d）.abcdInterventionalRadiologyDepartmentofWuhanUnionHospitalFigure3.TheimagesofMRIshowthelongsegmentorganizationthrombusinIVC(b,arrowhead).abInterventionalRadiologyDepartmentofWuhanUnio

8、nHospitalFigure4.(a,b)AngiographyshowslongsegmentocclusionandtheirregularfillingdefectinIVC,whichreachsthelevelofleftrenalveinoutlet(arrowhead).Puncturetheoccl