Endovascular therapy for hepatic artery stenosis and thrombosis following liver transplantation

Vasc Endovascular Surg. 2011 Jul;45(5):447-52. doi: 10.1177/1538574411407088. Epub 2011 May 13.

Abstract

Purpose: To evaluate the effectiveness of endovascular management of steno-oclusive disease in liver transplants.

Methods: Retrospective review of liver transplant recipients with hepatic artery stenosis (HAS) or thrombosis (HAT) was performed. The HAS group was treated with balloon angioplasty with selective stent placement. The HAT group was treated with catheter-directed thrombolysis. Primary, unassisted, and assisted patency and graft survival rates were calculated.

Results: In all, 31 patients were identified (21 males; mean age, 51 years). A total of 25 of 31 (81%) patients had HAS and 6 of 31 (19%) had HAT. Collectively, a total of 35 endovascular procedures were performed to treat HAS in 25 patients. Overall technical success rate was 91%, with 11% major complication rate. Primary-assisted patency rate and graft survival at 6 and 12 months were 87% and 81%, and 76% and 72%, respectively. Only 1 successful thrombolysis of HAT was achieved.

Conclusion: Endovascular management is effective for HAS but not for HAT.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Angiography, Digital Subtraction
  • Angioplasty, Balloon* / adverse effects
  • Angioplasty, Balloon* / instrumentation
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / etiology
  • Arterial Occlusive Diseases / physiopathology
  • Arterial Occlusive Diseases / therapy*
  • Constriction, Pathologic
  • Female
  • Graft Occlusion, Vascular / diagnostic imaging
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / physiopathology
  • Graft Occlusion, Vascular / therapy*
  • Graft Survival
  • Hepatic Artery / diagnostic imaging
  • Hepatic Artery / physiopathology
  • Hepatic Artery / surgery*
  • Humans
  • Kaplan-Meier Estimate
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents
  • Thrombolytic Therapy* / adverse effects
  • Thrombosis / diagnostic imaging
  • Thrombosis / etiology
  • Thrombosis / physiopathology
  • Thrombosis / therapy*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency
  • Virginia
  • Young Adult