Percutaneous Balloon Angioplasty in Membranous Obstruction of Inferior Vena Cava with Massive Thrombi:A Case Report

使用氣球擴張術治療下腔靜脈膜狀阻塞伴隨大量血栓：病例報告

林昭男(Jau-Nan Lin) ； 吳定國(Ding-Kwo Wu) ； 石明誠(Pau Ming-Chen Shih) ； 郭禹廷(Yu-Ting Kuo) ； 劉金昌(Gin-Chung Liu) ； 陳信成(Hsin-Chen Chen) ； 蔡宏名(Hong-Ming Tsai)

《中華放射線醫學雜誌》 28卷5期 (2003/10) Pp. 339-345

摘要

我們報告利用氣球導管擴張術成功的治療肝內下腔靜脈膜狀阻塞合併大量血栓的病例。此位四十五歲的女性病患表現出全身不適及下肢水腫，磁振掃描及血管攝影顯示為肝內下腔靜脈膜狀阻塞合併大量血栓。我們施行二階段的氣球擴張術並給予抗凝血劑。此法防止嚴重肺栓塞的併發症且有效的去除血栓。第一次的氣球擴張術是以八毫米口徑的氣球導管，之後病人的症狀明顯改善。第二次的氣球擴張數則在四個月之後以十八毫米口徑的氣球導管進行。

關鍵字

Budd-Chari症候 ； 下腔靜脈膜狀阻塞 ； 氣球擴張術

並列摘要

We report the successful treatment of Budd-Chiari syndrome caused by membranous obstruction of intrahepatic inferior vena cava (MOVC) with large amount of thrombi by ballon angioplasty. A 45-year-old woman developed general malaise and edema of legs. MOVC with large thrombi was diagnosed after MR angiogram and vena cavogram. We performed two-stage percutaneous transluminal angioplasty (PTA) with anticoagulant therapy. This strategy brought about interval resolution of thrombi and prevented the potential complication of massive pulmonary embolism. The first PTA was carried out with an 8 mm balloon catheter tailored for creation of substantial patency with forward flow of inferior vena cava (IVC) and yet to avoid massive pulmonary arterial embolization. The symptoms and signs got improved after the first PTA. The second PTA was performed with an 18 mm balloon catheter four months later, at which time only minimal residual thrombi retained.

並列關鍵字

Budd-Chiari syndrome ； Membranous obstruction of inferior vena cava ； Percutaneous transluminal angioplasty