复杂类型布加综合征的介入治疗

1、会计学1复杂类型布加综合征的介入治疗复杂类型布加综合征的介入治疗Interventional Radiology Department of Wuhan Union Hospital第1页/共31页Interventional Radiology Department of Wuhan Union Hospital第2页/共31页Interventional Radiology Department of Wuhan Union Hospital第3页/共31页Interventional Radiology Department of Wuhan Union Hospital第4页/共31页

2、Interventional Radiology Department of Wuhan Union HospitalFigure 1. (a,b) A-P and LP angiography show the occlusion segment length is 8.2cm. (c,d) Using TIPS puncture needle reconstrcuted the occlusion segment. a b c d 第5页/共31页Interventional Radiology Department of Wuhan Union HospitalFigure 1. The

3、 same patient. Using balloon dilated the occlusion segment and release Z-shape ES in IVC (eh).e f g h 第6页/共31页Interventional Radiology Department of Wuhan Union Hospital第7页/共31页Interventional Radiology Department of Wuhan Union HospitalFigure 2. Angiography of IVC shows the giant filling defect in I

4、VC (a) and contrast medium contaminated the thrombus(b). Using UK injection from the catheter two days later ,there is no sign of thrombus(c) and puncture the occlusion segment successfully（d）.a b c d 第8页/共31页Interventional Radiology Department of Wuhan Union HospitalFigure 3. The images of MRI show

5、 the long segment organization thrombus in IVC(b, arrow head).a b 第9页/共31页Interventional Radiology Department of Wuhan Union HospitalFigure 4. (a,b) Angiography shows long segment occlusion and the irregular filling defect in IVC, which reachs the level of left renal vein outlet(arrow head). Punctur

6、e the occlusion and dilated it with balloon(c,d).a b c d 第10页/共31页Interventional Radiology Department of Wuhan Union Hospitale f g h Figure 4. (e,f) Using a bigger balloon dilated the occlusion segment and release Z-shape ES to fix the thrombus on the wall of IVC.第11页/共31页Interventional Radiology De

7、partment of Wuhan Union Hospital第12页/共31页Interventional Radiology Department of Wuhan Union Hospitala Figure 5. (a) The angiography from IVC. (b) The angiography after percutaneous puncture the occlusion HV. (c) Angiography through catheter after balloon dilatation. (d) Release ES.b c d 第13页/共31页Int

8、erventional Radiology Department of Wuhan Union HospitalFigure 6. Percutaneous puncture the occlusion HV under US guiding. (a)diagram.(b)in operation . a b 第14页/共31页Interventional Radiology Department of Wuhan Union HospitalFigure 7. (a)Angiography form IVC.( b) percutaneous puncture the occlusion H

9、V under US guiding. (c,d)guide wire track and balloon dilatation. (e,f) without occlusion signs after operation.a b c d e f 第15页/共31页Interventional Radiology Department of Wuhan Union Hospital第16页/共31页Interventional Radiology Department of Wuhan Union HospitalFigure 8. (a) Fine needle puncture HV an

10、d angiography for guiding.(bd) try to puncture the occlusion HV cannot succeed from jugular way. (e,f) femoral way succeed.a b c d e f 第17页/共31页Interventional Radiology Department of Wuhan Union HospitalFigure 9. The same patient. (a,b)lagre amount ascits before operation(T2WI imge of MRI).(c)frog b

11、elly (peroperative). (d) ascits dismissed (post-operative).a b c d 第18页/共31页Interventional Radiology Department of Wuhan Union Hospital*Xu PQ, Ma XX, Ye xx, et al. Surgial Treatment of 1360 cases of Budd-Chiari Syndrome:20-year Experience. Hepatobiliary Pancreat Dis int, 2004, 3(3):391-394.第19页/共31页

12、Interventional Radiology Department of Wuhan Union HospitalFigure 10. (a) Percutaneous puncture PV for guiding. (b,d) Reconstruction the shunt between PV and HV. (e,f) Angiography after operation.a b c d e f 第20页/共31页Interventional Radiology Department of Wuhan Union HospitalFigure 11. (a) Directly

13、puncture into IVC from rPV. (bd) Reconstruction the shunt between PV and HV. (e) Schematic diagram of directly puncture IVC.a b c d e 第21页/共31页Interventional Radiology Department of Wuhan Union Hospital第22页/共31页Interventional Radiology Department of Wuhan Union HospitalFigure 12.（ac）IVC was recanali

14、zed firstly. (d,e) Puncture the occlusion HV secondly. (f) The angiography after operation.a b c d e f 第23页/共31页Interventional Radiology Department of Wuhan Union Hospital第24页/共31页Interventional Radiology Department of Wuhan Union Hospital第25页/共31页Interventional Radiology Department of Wuhan Union H

15、ospital第26页/共31页Interventional Radiology Department of Wuhan Union HospitalFigure 1. The same patient. Using balloon dilated the occlusion segment and release Z-shape ES in IVC (eh).e f g h 第27页/共31页Interventional Radiology Department of Wuhan Union HospitalFigure 7. (a)Angiography form IVC.( b) percutaneous puncture the occlusion HV under US guiding. (c,d)guide wire track and balloon dilatation. (e,f) without occlusion signs after operation.a b c d e f 第28页/共31页Interventional Radiology Department of