Fluency覆膜支架的近端位置对经颈静脉肝内门体分流术通畅期的影响  

Effect of proximal position of Fluency covered stent on patency of transjugular intrahepatic portosystemic shunt

作　　者：刘笑默 刘臻[1] LIU Xiao-mo;LIU Zhen(Shengjing Hospital,China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院,辽宁沈阳110004

出　　处：《中国临床医学影像杂志》2023年第4期285-288,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨Fluency覆膜支架作为经颈静脉肝内门体分流术(TIPS)分流支架,其近端位置对TIPS通畅期的影响。方法:收集以Fluency作为分流支架的TIPS手术,回顾其临床资料及术中造影情况。结果:收集到165例TIPS患者,按照支架的近端位置在DSA透视下是否超出肝脏轮廓分组并做比较,通畅期(21.57±11.66 vs.16.51±12.48,P=0.009)、12月的通畅率(68.09%vs.50.7%,P=0.024)、TIPS补救治疗率存在显著差异(2.13%vs.21.13%,P<0.001)。支架近端是否超出肝脏轮廓是影响支架通畅期的独立因素(P<0.001)。支架近端超出肝脏轮廓的通畅期显著提高,HR=6.763(95%CI 3.338~13.701)。通过Kaplan-Meier曲线表示,支架近端超过肝脏轮廓组显著优于支架近端不超过肝脏轮廓组。结论:以Fluency作为TIPS分流支架,其近端在DSA下超过肝脏轮廓可提高支架通畅期。Objective:To investigate the effect of proximal position of Fluency covered stent as shunt stent in transjugular intrahepatic portosystemic shunt(TIPS)on the patency of TIPS.Methods:The clinical data and intraoperative angiography of TIPS with Fluency as shunt stent were reviewed.Results:One hundred and sixty-five patients with TIPS were divided into groups according to whether the proximal position of the stent was exceeding the liver contour under DSA fluoroscopy and compared.The patency period(21.57±11.66 vs.16.51±12.48,P=0.009),12 month patency rate(68.09%vs.50.7%,P=0.024),and the rate of TIPS revision were significantly different(2.13%vs.21.13%,P<0.001).Whether the proximal end of the stent exceeded the contour of the liver was an independent factor affecting the patency of the stent(P<0.001).The patency of the proximal stent exceeding the liver contour was significantly improved,HR=6.763(95%CI 3.338~13.701).The Kaplan-Meier curve showed that the group with the proximal end of the stent exceeding the liver contour was significantly better than the group with the proximal end of the stent not exceeding the liver contour.Conclusion:Fluency as a TIPS shunt stent,whose proximal end exceeds the contour of the liver under DSA can improve the patency of the stent.

关 键 词：门体分流术 经颈静脉肝内 支架 放射学 介入性 

分 类 号：R657.3[医药卫生—外科学] R815[医药卫生—临床医学]