[Clinical application and efficacy of TIPS combined with AngioJet mechanical thrombectomy for liver cirrhosis with extensive portal vein thrombosis].

Objective: To assess the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with AngioJet mechanical thrombectomy for liver cirrhosis with extensive portal vein thrombosis. Methods: From March 2018 to April 2019, a total of 11 patients with liver cirrhosis and extensive portal vein thrombosis were treated by TIPS combined with AngioJet mechanical thrombectomy, including 6 males and 5 females, with the age of 37-71 (46±9) years old, 3 cases of Child-Pugh grade A, 8 cases of grade B and 0 cases of grade C. The intraoperative immediate thrombus clearance rate, perioperative complication rate, postoperative thrombus recurrence rate, rebleeding rate, the incidence of hepatic encephalopathy and the rate of stent patency of all cases were collected and analyzed. Results: All the patients were treated successfully. The immediate complete thrombus clearance (grade Ⅲ) rate of portal vein trunk was 9/11, and grade Ⅱ was 2/11, The average dose of urokinase was 30-60 (40±5) ten thousand U, slight puncture point bleeding occurred in 3 cases, and recurrence of PVT in portal vein trunk occurred in 1 case with Ⅱ grade clearance rate after operation, rebleeding occurred in 1 case, hepatic encephalopathy occurred in 2 cases, the primary patency rate of stents was 9 cases. Conclusion: TIPS combined with AngioJet mechanical thrombectomy can treat the liver cirrhosis with extensive portal vein thrombosis effectively and safely, and postoperative portal vein patency rate and intrahepatic shunt patency rate are high.目的： 评价经颈静脉肝内门体分流术（TIPS）联合AngioJet血栓清除装置治疗肝硬化急性门静脉广泛血栓形成的安全性和疗效。 方法： 回顾性分析2018年3月至2019年4月在郑州大学第一附属医院东院区行TIPS联合AngioJet血栓清除装置治疗的肝硬化急性门静脉血栓患者11例，男6例、女5例，年龄37~71（46±9）岁，肝功能Child-Pugh A级3例、B级8例、C级0例，观察术中即刻血栓清除率、围手术期并发症发生率、术后血栓复发率、再出血率、肝性脑病发生率及支架通畅率。 结果： 患者均治疗成功，门静脉主干即刻血栓Ⅲ级清除率9/11，Ⅱ级清除率2/11；尿激酶用量30~60（40±5）万U，穿刺点轻微渗血3例，术后门静脉血栓复发1例，再出血1例，肝性脑病2例，支架一期通畅9例。 结论： TIPS联合AngioJet血栓清除装置治疗肝硬化急性门静脉血栓形成安全、有效，术后门静脉通畅率及肝内分流道通畅率高。.