目的观察Habib~(TM) VesOpen射频消融导管对门脉癌栓进行血管内治疗联合覆膜支架植入的临床效果,探索术中门脉癌栓组织活检的安全性和可行性。方法选择自2014年6月~2015年12月肝癌门脉癌栓患者13例,应用Habib消融导管血管内射频消融联合覆膜支架植入治疗。在造影了解癌栓的部位、范围后;采用5F活检钳在透视下对癌栓抓取活检共3例;然后自鞘内送5F Habib~(TM) VesOpen射频消融导管至癌栓对癌栓行逐段消融,结束后对消融段植入覆膜支架。术后观察患者临床症状改善情况及生存状况,并实验室相关指标复查及影像学检查,观察门静脉癌栓消融治疗后的状态3~18个月。结果所有13例患者均顺利实施了血管内射频消融联合覆膜支架植入,无严重并发症发生。3例Ⅱ型癌栓者成功活检送病理,2例增生型,1例坏死型。9例上腹胀满者术后明显缓解;4例合并腹腔积液者中2例明显缓解,2例完全消失;1例顽固性腹泻者术后第3天停止。随访3~18个月,6例Ⅱ型癌栓者病情稳定,消融通道血流通畅,1例Ⅱ型、5例Ⅲ型和1例Ⅳ型癌栓者先后出现癌栓进展,消融通道狭窄甚至闭塞。生存时间超过3个月者12例;超过6个月10例;超过12个月8例;超过18个月5例。结论 Habib~(TM) VesOpen消融导管对门脉癌栓进行血管内射频消融联合覆膜支架植入可能获得比单纯血管内消融更好的疗效。在血管鞘的保护下,用活检钳对癌栓进行抓取活检技术上是安全可行的。 Objective To observe the clinical effect of Habib TM VesOpen radiofrequency ablation catheter on endovascular thrombosis treated with endovascular stent graft, and to explore the safety and feasibility of biopsy of portal vein thrombosis. Methods Thirteen patients with hepatocellular carcinoma with portal vein tumor thrombus were recruited from June 2014 to December 2015. The patients were treated with intravascular radiofrequency catheter ablation and stenting with Habib ablation catheter. In the angiography to understand the location of the thrombus, after the scope; using 5F biopsy forceps in the perspective of the tumor thrombus grasping a total of 3 cases; and then from the sheath to send 5F Habib ~ (TM) VesOpen RF ablation catheter to embolism Ablation section by section, the end of the ablation segment implants stent graft. Postoperative observation of patients with clinical symptoms improved and living conditions, and laboratory related indicators review and imaging studies to observe the portal vein thrombolysis ablation after treatment for 3 to 18 months. Results All 13 patients underwent successful intravascular radiofrequency catheter ablation and stent implantation without serious complications. Three cases of type Ⅱ thrombus were successfully biopsied and pathologically confirmed. Two cases were hyperplastic and one was necrotic. 9 cases of patients with abdominal fullness were significantly relieved postoperatively; 4 cases of patients with ascites were significantly relieved, 2 cases completely disappeared; 1 case of intractable diarrhea stopped after 3 days. During the follow-up of 3 to 18 months, 6 patients with type Ⅱ thrombus had stable disease, blood flow was clear in the ablation channel, 1 case of type Ⅱ, 5 cases of type Ⅲ and 1 case of type Ⅳ thrombus had thrombus progression, narrowing of ablation channels or even Blocked. 12 cases survived for more than 3 months; 10 cases more than 6 months; 8 cases more than 12 months; 5 cases more than 18 months. Conclusion Intravascular radiofrequency catheter ablation combined with stenting with Habib ™ VesOpen catheter for ablation of portal vein tumor thrombus may be more effective than simple endovascular ablation. In the protection of the vascular sheath, biopsy with biopsy forceps on the tumor embolus is safe and feasible.