杨宁介入医学网

病例：Lower Pole Selection 脾50% 萎缩 究竟栓塞多少脾？ Zhu K 2009 Dig Liver Dis To insure a sustained and long-term increase in platelet and leucocyte counts, the splenic infarction rate needs to be greater than 50% Madoff 2012 JVIR Traditi...

Summary PSE useful and reasonably safe Much work needs to be done to refine and define optimal technique...

脾动脉栓塞并发症发生相关因素 并发症 vs 部分脾栓塞% 门静脉高压脾亢：回顾性评价17例患者脾栓塞的结果 Petermann et al Diagn Interv Imaging 93(1): 30-36 17 患者：部分脾栓塞＞70%，并发症发生率50% 部分脾栓塞＜70%，并发症发生率＜70%。...

62 pts 1- to 2-mm gelfoam particles suspended in gentamicin Follow-up - 5 years 分组 A B C 梗死% 70% 50-70% 50% 患者数 12 34 16 严重并发症 50% 8.8% 0% 中位住院时间(天) 16 9 5 Zhu - 2009 Dig Liver Dis 41:411（朱康顺） ....

主脾动脉栓塞 vs 部分脾动脉栓塞 （Main Splenic Art Embo vs PSE） 61 pts with hypersplenism caused by cirrhosis Non-randomized prospective trial TSAE embo of main splenic art with coils PSE peripheral splenic embo with gelfoam or PVA TSAE PS...

Catheter Position Proximal vs Distal 主脾动脉栓塞（Main splenic artery） - Quicker - Can be done without micro-catheters 选择性末段脾动脉分支栓塞 Sub-selecting distal splenic branches - 花更多的操作时间； （ Takes more time） - 需要微导管...

Embolic Agents Used for PSE Gelfoam PVA - Zhu et al 2008 Eur J Radiol 用PVA 部分脾栓塞术后，血小板增加显著 Tris-acryl gelatin microspheres Onyx Coils...

改善血液学的参数 To improve hematologic parameter - 地中海贫血 （珠蛋白生成障碍性贫血）Thalassemia - 特发性血小板性紫癜 Idiopathic thrombocytopenic pupura 纠正脾功能亢进血小板减少 To correct hypersplenism thrombocytopenia - 限制或妨碍化疗...

Amin - 2009 World J Surg 33:1702 N =40 肝硬化脾亢病人； 20 pts 用PVA 进行＞50脾栓塞 20 pts 进行脾切除 两组血小板计数均显著增加 并发症 部分脾栓塞 - 1 MI，1 脾脓肿，1 门静脉血栓 脾切除- 3 门静脉血栓 脾切除手术时间长，住院时间长，需要输血。...

脾亢脾动脉栓塞 SPLENIC ARTERY EMBOLISATION FOR HYPERSPLENISM 部分脾栓塞Partial Splenic Embolization (PSE) First performed by Spigos et al in 1979 AJR 132: 777-782...