复杂类型布-加综合征的介入治疗.ppt

《复杂类型布-加综合征的介入治疗.ppt》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

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：overviewGeneraldefinitionClassificationPathologicalchangeClinicalmanifestatio

2、nTherapy.inverventionaltherapyisthefirstchoice.InterventionalRadiologyDepartmentofWuhanUnionHospitalPart2：complexBCSIVC.longsegmentocclusion.combiningwiththrombosisHV.segementocclusion.widespreadocclusionOcclusionofHV&IVCInterventionalRadiologyDepartmentofWuhanUnionHospitalPart

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

4、anUnionHospitalFigure1.(a,b)A-PandLPangiographyshowtheocclusionsegmentlengthis8.2cm.(c,d)UsingTIPSpunctureneedlereconstrcutedtheocclusionsegment.abcdInterventionalRadiologyDepartmentofWuhanUnionHospitalFigure1.Thesamepatient.UsingballoondilatedtheocclusionsegmentandreleaseZ-sha

5、peESinIVC(e～h).efghInterventionalRadiologyDepartmentofWuhanUnionHospitalIVC：occlusion&thrombosisD.D.ofthrombus:per-operationFreshthrombus：thrombolysis&suction&/.micro-caliberpunctureOrganizedthrombus：mini-caliberpuncture&ES&dilatationThrombolysis&anticoagulation:postoperationIn

6、terventionalRadiologyDepartmentofWuhanUnionHospitalFigure2.AngiographyofIVCshowsthegiantfillingdefectinIVC(a)andcontrastmediumcontaminatedthethrombus(b).UsingUKinjectionfromthecathetertwodayslater,thereisnosignofthrombus(c)andpuncturetheocclusionsegmentsuccessfully（d）.abcdInter

7、ventionalRadiologyDepartmentofWuhanUnionHospitalFigure3.TheimagesofMRIshowthelongsegmentorganizationthrombusinIVC(b,arrowhead).abInterventionalRadiologyDepartmentofWuhanUnionHospitalFigure4.(a,b)AngiographyshowslongsegmentocclusionandtheirregularfillingdefectinIVC,whichreachsth

8、elevelofleftrenalveinoutlet(arrowhead).Puncturetheoccl