METHOD OF PREVENTION AND TREATMENT OF VARICEAL BLEEDING IN PORTAL HYPERTENSION OF CIRRHOTIC GENESIS

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to surgery. Transjugular intrahepatic portosystemic shunting (TIPS) is carried out. Wherein, during the TIPS operation, selective embolization of all variceal-expanded visceral veins and collateral discharges is performed. After parenchymal canal is created in liver tissue, a catheter is conducted via conductor through the formed canal into the portal vein and a selective angiography of the portal vein is performed. While, all the variceal-expanded visceral veins and collateral discharges into the systemic circulation are detected, which then a catheter is alternately inserted into along the conductor for material to be introduced. Embolization of variceal veins and collateral discharges is performed. Then, selective angiography of the portal vein is repeated, and with full embolization of all variceal veins, the expansion of the canal created in the liver parenchyma is performed by a balloon catheter, after which a self-expanding stent-graft is implanted into the parenchymal canal, which is fixed by radiopaque marks on it. Stent graft delivery system is removed and the stent graft is expanded to a diameter of 8 to 10 mm by a balloon catheter. Puncture vessels are then closed. In case of incomplete embolization of all variceal veins, additional embolization is performed and then also stent-graft implantation is performed.;EFFECT: method allows to effectively and safely stop continued bleeding, reduce the number of relapse bleeding from varicose veins and increase the survival rate of patients with portal hypertension of cirrhotic origin.;1 cl, 1 ex