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：overviewGeneraldefinitionClassificationPathologicalchangeClinicalma

2、nifestationTherapy.inverventionaltherapyisthefirstchoice.InterventionalRadiologyDepartmentofWuhanUnionHospitalPart2：complexBCSIVC.longsegmentocclusion.combiningwiththrombosisHV.segementocclusion.widespreadocclusionOcclusionofHV&IVCInterventionalRadiologyDepartmentofWu

3、hanUnionHospitalPart3：therapy&casesreportInterventionalRadiologyDepartmentofWuhanUnionHospitalIVC：longsegementocclusionAnatomyofIVC：pre-operationAngiography：two-way&multipledirectionsPuncture：resistingforce&directionsTrackofguidewireDilatationEndovascularstentInterven

4、tionalRadiologyDepartmentofWuhanUnionHospitalFigure1.(a,b)A-PandLPangiographyshowtheocclusionsegmentlengthis8.2cm.(c,d)UsingTIPSpunctureneedlereconstrcutedtheocclusionsegment.abcdInterventionalRadiologyDepartmentofWuhanUnionHospitalFigure1.Thesamepatient.Usingballoond

5、ilatedtheocclusionsegmentandreleaseZ-shapeESinIVC(e～h).efghInterventionalRadiologyDepartmentofWuhanUnionHospitalIVC：occlusion&thrombosisD.D.ofthrombus:per-operationFreshthrombus：thrombolysis&suction&/.micro-caliberpunctureOrganizedthrombus：mini-caliberpuncture&ES&dila

6、tationThrombolysis&anticoagulation:postoperationInterventionalRadiologyDepartmentofWuhanUnionHospitalFigure2.AngiographyofIVCshowsthegiantfillingdefectinIVC(a)andcontrastmediumcontaminatedthethrombus(b).UsingUKinjectionfromthecathetertwodayslater,thereisnosignofthromb

7、us(c)andpuncturetheocclusionsegmentsuccessfully（d）.abcdInterventionalRadiologyDepartmentofWuhanUnionHospitalFigure3.TheimagesofMRIshowthelongsegmentorganizationthrombusinIVC(b,arrowhead).abInterventionalRadiologyDepartmentofWuhanUnionHospitalFigure4.(a,b)Angiographysh

8、owslongsegmentocclusionandtheirregularfillingdefectinIVC,whichreachsthelevelofleftrenalveinoutlet(arrowhead).Puncturetheoccl