The Anatomical Basis Of Interventional Radiology For Budd-chiari Syndrome

Objective:To systematically study regional anatomy of retroheatic segmentof inferior vena cava and hepatic veins,in order to provide anatomical basisfor interventional radiology for Budd-Chiari syndrome,and a preliminarydiscussion of choice the type and repuirment of stents in BCS.Methods:20samples of adult corpses with undamaged retroheatic segmentof inferior vena cava and hepatic veins and40liver specimens wereselected.The shape、each paragraph length、diameter of RHSIVC and theshape、distribution、caliber of HVs and the length of trunk to the firstbranch of the MHVs were observed and measured. To analysis of thefeatures of RHSIVC and HVs with result combine with the literature aboutRHSIVC and HVs anatomy.Results:The shape of RHSIVC was most of eft turn, the average length ofRHSIVC in pericardium with (22.3±9.1)mm、liver section with (61.3±11.1)mm.The IVC cross diaphragmatic place with a mean diameter of (21.5 ±11.5)mm.The left and middle HV formed a commom trunk in44cases(73.3%),the3MHVs had separate inflow into IVC in16cases(26.6%).The mean diameter of MHVs (the right(13.2±3.3)mm、themiddle(10.1±0.8)mm、the lef（t9.2±0.8）mm).The length of the trunk of theright MHVs was (18.4±4.0）mm,middle MHVs was (15.1±2.7)mm, leftMHVs was (22.1±3.2)mm.Short hepatic veins variation was bigger, theaverage number of them was6.52, and the number of the diameter of trunkgreater than10.0mm was24.The incidence rate of IRHV was61.6%(37/60)with a average diameter of (7.2±1.4)mm.Conclusion The big balloon of diameter25mm-30mm could expand theinferior vena cava security;The length of first section of the stent should be1-2cm, can reduce the malignant arrhythmia caused by the stent into theright atrium;The diameter of expansion balloon and stents for the hepaticvein should be within10to20mm, and the length of stents within15to20mm,can avoid the oppression to main branch of HVs.The SHVs wouldbecome larger in BCS,and the IRHV could be used to treat BCS throughTIPS.