关键词: 颈静脉肝内门体分流术, 支架, 狭窄, 闭塞, 介入治疗

Abstract:

Objective To summarize the interventional treatment strategy of stent restenosis or occlusion after transjugular intrahepatic portosystemic shunt (TIPS). Methods The data collected from 20 patients (10 males and 5 females, aged 27-58 years, averaged 48 years) with stent restenosis or occlusion after TIPS from Jan.2009 to Dec.2011 were retrospectively analyzed. 12 patients with stent restenosis and 8 patients with stent occlusion were confirmed by ultrasonography before surgery and intraoperative DSA. All patients were used bare metal stent. 4 patients were performed ballon dilation,11 patients were re-stented after ballon dilation, and 5 patients accepted the second Tips to reconstruct the shut. Results Free portal pressure (FPP) was reduced from(3.94±0.52)kPa to(2.55±0.46)kPa (P<0.05), 3 patients with hepatic coma improved after drug treatment within one week postoperatively. All patients underwent warfarin anticoagulation after intervention. There was no stent restenosis or occlusion during follow-up of 1.5 years. Conclusion The shunt stent has a certain rate of restenosis or occlusion after TIPS, but the prior stent can be expended and the shunt can be reconstructed with interventional techniques, it has the extremely application value in reducing portal pressure and extending the survival of patients.

Key words: transjugular intrahepatic portosystemic shunt, stent, restenosis, occlusion, interventional treatment