Transjugular intrahepatic portosystemic shunt with radioactive seed strand for main portal vein tumor thrombosis with cirrhotic portal hypertension

作     者：Xuan-Hui Yan Zhen-Dong Yue Hong-Wei Zhao Lei Wang Zhen-Hua Fan Yi-Fan Wu Ming-Ming Meng Ke Zhang Li Jiang Hui-Guo Ding Yue-Ning Zhang Yong-Ping Yang Fu-Quan Liu 

作者机构：Department of Interventional TherapyPeking University Ninth School of Clinical MedicineBeijing Shijitan HospitalBeijing 100038China Department of Interventional TherapyBeijing Shijitan HospitalCapital Medical UniversityBeijing 100038China Department of Interventional TherapyBeijing Tongren HospitalCapital Medical UniversityBeijing 100005China Department of GastroenterologyBeijing Shijitan HospitalCapital Medical UniversityBeijing 100038China Department of General SurgeryBeijing Ditan HospitalCapital Medical UniversityBeijing 100102China Department of GastroenterologyBeijing You'an HospitalCapital Medical UniversityBeijing 100069China Department of Liver Disease Digestion CenterBeijing You'an HospitalCapital Medical UniversityBeijing 100069China Department of Liver DiseaseThe Fifth Medical Center of Chinese PLA General HospitalBeijing 100039China 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2022年第14卷第6期

页      面：567-579页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by Beijing Municipal Science and Technology Commission project,The Capital of The Public Health Cultivation,No.Z171100000417031 The Capital Health Research and Development of Special,Beijing Municipal,Health Commission,No.2018-1-2081 Scientific Research Common Program of Beijing Municipal Commission of Education,No.KM201810025028 (to Liu FQ) 

主　　题：Transjugular intrahepatic portosystemic shunt Radioactive seed strand Portal vein tumor thrombosis Hepatocellular carcinoma Cirrhotic portal hypertension Cirrhosis 

摘      要：BACKGROUND Patients with hepatocellular carcinoma complicated with main portal vein tumor thrombosis(mPVTT) and cirrhotic portal hypertension(CPH) have an extremely poor prognosis, and there is a lack of a clinically effective treatment *** To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt(TIPS)combined with radioactive seed strand for the treatment of mPVTT patients with *** The clinical data of 83 consecutive patients who underwent TIPS combined with 125I seed strand placement for mPVTT and CPH from January 2015 to December 2018 were retrospectively reviewed. Procedure-related data(success rate, relief of portal vein pressure and CPH symptoms,and adverse events), PVTT response, and patient survival were assessed through a 2-year *** The success rate was 100.0% without perioperative death or procedure-related severe adverse events. The mean portal vein pressure was significantly decreased after the procedure(22.25 ± 7.33mmHg vs 35.12 ± 7.94 mmHg, t = 20.61, P 0.001). The symptoms of CPH were all effectively relieved within 1 mo. The objective response rate of PVTT was 67.5%. During a mean follow-up of 14.5 ± 9.4 mo(range 1-37 mo), the cumulative survival rates at 6, 12 and 24 mo were 83.1%, 49.7%,and 21.8%, respectively. The median survival time was 12.0 ± 1.3 mo(95% confidence interval: 9.5-14.5). In multivariate Cox regression analysis, body mass index, Child-Pugh grade, cTNM stage,and PVTT response were independent prognostic factors(P 0.05).CONCLUSION TIPS combined with radioactive seed strand might be effective and safe in treating mPVTT patients with CPH.