Download PDF
Semin intervent Radiol 2019; 36(02): 133-136
DOI: 10.1055/s-0039-1688428
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Percutaneous Transarterial Stent Placement in a Transplant Liver Hepatic Artery Complicated by Angioplasty Balloon Rupture and Fragmentation

Jenanan P. Vairavamurthy
1   Division of Interventional Radiology, Department of Radiology, Keck School of Medicine of the University of Southern California, Los Angeles, California
,
Charles Li
1   Division of Interventional Radiology, Department of Radiology, Keck School of Medicine of the University of Southern California, Los Angeles, California
,
Seth Urban
1   Division of Interventional Radiology, Department of Radiology, Keck School of Medicine of the University of Southern California, Los Angeles, California
,
Michael Katz
1   Division of Interventional Radiology, Department of Radiology, Keck School of Medicine of the University of Southern California, Los Angeles, California
› Author Affiliations
Further Information

Publication History

Publication Date:
22 May 2019 (online)

Also available at
    Permissions and Reprints

Abstract

The incidence of posttransplant hepatic arterial stenosis (HAS) has been reported in 5 to 10% of orthotopic liver transplants and, left untreated, can lead to hepatic arterial thrombosis. Most vascular complications develop less than 3 months after initial transplant, with thrombosis representing over half of all complications. There has been a trend toward minimally invasive, endovascular techniques for treating HAS with angioplasty and stenting. In one review of endovascular therapies for HAS, primary technical success was achieved in 95% of the interventions. Complication rates following endovascular repair of HAS have been reported to be between 0 and 23% in the literature. The main risk factors for complications include tortuosity of the hepatic artery and history of a second liver transplant. Other associated risk factors include female gender, age greater than 60 years, prior history of transarterial chemoembolization, and multiple arterial graft anastomoses. The case presented here is representative of a complication of balloon rupture and fragmentation in a patient undergoing hepatic arterial stent placement post–liver transplant.

Keywords

liver transplant - arterial stent - interventional radiology

Financial Disclosure

The authors have no relevant financial disclosures.


 

  • References

  • 1 Le L, Terral W, Zea N. , et al. Primary stent placement for hepatic artery stenosis after liver transplantation. J Vasc Surg 2015; 62 (03) 704-709
    CrossrefPubMedGoogle Scholar
  • 2 Sabri SS, Saad WEA, Schmitt TM. , et al. Endovascular therapy for hepatic artery stenosis and thrombosis following liver transplantation. Vasc Endovascular Surg 2011; 45 (05) 447-452
    CrossrefPubMedGoogle Scholar
  • 3 Xue Z, Chen M, Zhang X. , et al. Analysis of early hepatic artery thrombosis after liver transplantation. ANZ J Surg 2018; 88 (03) 172-176
    CrossrefPubMedGoogle Scholar
  • 4 Bekker J, Ploem S, de Jong KP. Early hepatic artery thrombosis after liver transplantation: a systematic review of the incidence, outcome and risk factors. Am J Transplant 2009; 9 (04) 746-757
    CrossrefPubMedGoogle Scholar
  • 5 Duffy JP, Hong JC, Farmer DG. , et al. Vascular complications of orthotopic liver transplantation: experience in more than 4,200 patients. J Am Coll Surg 2009; 208 (05) 896-903 , discussion 903–905
    CrossrefPubMedGoogle Scholar
  • 6 Rajakannu M, Awad S, Ciacio O. , et al. Intention-to-treat analysis of percutaneous endovascular treatment of hepatic artery stenosis after orthotopic liver transplantation. Liver Transpl 2016; 22 (07) 923-933
    CrossrefPubMedGoogle Scholar
  • 7 Goldsmith LE, Wiebke K, Seal J. , et al. Complications after endovascular treatment of hepatic artery stenosis after liver transplantation. J Vasc Surg 2017; 66 (05) 1488-1496
    CrossrefPubMedGoogle Scholar
  • 8 Sommacale D, Aoyagi T, Dondero F. , et al. Repeat endovascular treatment of recurring hepatic artery stenoses in orthotopic liver transplantation. Transpl Int 2013; 26 (06) 608-615
    CrossrefPubMedGoogle Scholar
  • 9 Vidjak V, Novačić K, Matijević F. , et al. Percutaneous endovascular treatment for hepatic artery stenosis after liver transplantation: the role of percutaneous endovascular treatment. Pol J Radiol 2015; 80: 309-316
    CrossrefPubMedGoogle Scholar
  • 10 Frongillo F, Lirosi MC, Nure E. , et al. Diagnosis and management of hepatic artery complications after liver transplantation. Transplant Proc 2015; 47 (07) 2150-2155
    CrossrefPubMedGoogle Scholar