转肝前期胃变节硬化疗法:与初始静脉栓塞并非初始静脉栓塞的结果进行比较
Shohei Harada1, Akira Yamamoto2, Atsushi Jogo2
1Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka City University, Osaka, Japan; Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
Journal of vascular and interventional radiology : JVIR
|October 10, 2024
概括
与初始 afferent 静脉栓塞 (PTO-A) 相比,通过皮肤通过肝脏的消灭与初始 afferent 静脉栓塞 (PTO-E) 实现了更高的胃静脉根除和更长的无复发期. 这项研究强调PTO-E作为更有效的治疗胃变节的方法.
科学领域:
- 干预性放射学 干预性放射学
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
背景情况:
- 胃静脉 (GVs) 具有显著的出血风险.
- 透皮透肝消灭 (PTO) 是对GVs的一种成熟的治疗方法.
- 在PTO中存在不同的栓塞策略,包括 afferent和efferent静脉方法.
研究的目的:
- 为了比较通过皮肤进行的透肝消灭与初始 afferent静脉栓塞 (PTO-A) 与初始 efferent静脉栓塞 (PTO-E) 治疗胃变节的有效性.
- 评估两种PTO技术的完全根除率,无复发期和整体存活率.
主要方法:
- 在2007年至2023年间,对26名连续患有胃变节的患者 (第1型隔离或第2型胃食道) 进行PTO的回顾性分析.
- 患者接受了PTO-A或PTO-E,在2009年3月之后尝试了PTO-E,PTO-A用于特定情况下或当PTO-E失败时.
- 主要结局是在一周内完全根除GV;次要结局包括无复发生存率和整体生存率.
主要成果:
- 在所有患者中都取得了技术上的成功.
- 与PTO-A (33.3%) 相比,PTO-E (100%) 的完全GV根除率显著更高 (P = .002).
- 与PTO-A (8.7个月) 相比,PTO-E的中位数无复发期 (75.1个月) 显著更长 (P = .042),整体存活率没有显著差异.
结论:
- 初始 afferent静脉栓塞 (PTO-E) 优于初始 afferent静脉栓塞 (PTO-A) 对于胃的治疗.
- PTO-E提供更好的完整根除率和持续的疾病控制,导致更长的无复发生存时间.
- 这些发现支持优先使用PTO-E用于胃静脉管理.
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