生物降解的聚合物插头用于通过皮肤或手术放置跨肝胆道排水管后的肝管栓塞:一个可行性研究
Annette Thurner1, Giulia Dalla Torre1, Viktor Hartung1
1Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany.
概括
这项研究发现,可生物降解的聚合物插头是胆管排水后肝管栓塞的可行选择,实现了高技术成功. 谨慎的超大尺寸和确保胆道脱血对于持久的关闭至关重要.
科学领域:
- 干预性放射学 干预性放射学
- 胃肠病学 胃肠病学
- 胆汁干预 胆汁干预
背景情况:
- 经肝胆道排水 (TBD) 可以导致与通道相关的不良事件 (AE).
- 对于TBD通道的栓塞是可取的,以防止并发症.
- 可生物降解的聚合物插头为精确的通道关闭提供了潜在的解决方案.
研究的目的:
- 评估使用可生物降解的聚合物插头在TBD后肝管栓塞的可行性和安全性.
- 评估插头栓塞手术的技术和临床成功率.
- 识别影响成功和不成功结果的因素.
主要方法:
- 在13名高风险患者中对15例塞栓栓塞进行了回顾性观察性研究.
- 在24小时,3个月和6个月后进行临床和成像随访.
- 评估技术成功 (部署),临床成功 (没有AE) 和二次终点 (迁移,超大小,可见性).
主要成果:
- 100%的技术成功率用于插头部署.
- 临床成功率为84.6%,没有传染性或出血性AE.
- 由于低估了胆道堵塞,发生了两个胆道AE (胆皮),与下插头超大 (27%与成功病例中的86%相比).
结论:
- 可生物降解的聚合物插头是肝管栓塞的一个可行的选择,当需要精确的,非永久的关闭时.
- 适当的插入到引进的超大尺寸和完整的胆道脱血对于持久的通道关闭至关重要.
- 插头可能不适合患有多层狭窄症的患者,在这种情况下无法实现完全的胆道排水.
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