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Catheter Thrombolysis of Thrombosed Hepatic Arteries in Liver Transplant Recipients: Predictors of Success and Role of Thrombolysis

Wael E. SaadDepartment of Imaging Sciences, Section of Vascular/Interventional Radiology, University of Rochester Medical Center, New York,Mark G. DaviesDepartment of Surgery, Division of Vascular Surgery, University of Rochester Medical Center, New YorkNael SaadDepartment of Imaging Sciences, Section of Vascular/Interventional Radiology, University of Rochester Medical Center, New YorkKarin E. WestessonSchool of Medicine and Dentistry, University of Rochester Medical Center, New YorkNikhil C. PatelDepartment of Imaging Sciences, Section of Vascular/Interventional Radiology, University of Rochester Medical Center, New YorkLawrence G. SahlerDepartment of Imaging Sciences, Section of Vascular/Interventional Radiology, University of Rochester Medical Center, New YorkDavid E. LeeDepartment of Imaging Sciences, Section of Vascular/Interventional Radiology, University of Rochester Medical Center, New YorkTakashi KitanosonoDepartment of Imaging Sciences, Section of Vascular/Interventional Radiology, University of Rochester Medical Center, New YorkTalia SassonDepartment of Imaging Sciences, Section of Vascular/Interventional Radiology, University of Rochester Medical Center, New YorkDavid L. WaldmanDepartment of Imaging Sciences, Section of Vascular/Interventional Radiology, University of Rochester Medical Center, New York

2007en

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Annotatsiya

Hepatic artery thrombosis is an uncommon complication of liver transplantation. However, it is a major indication for re-transplantation. The use of transcatheter thrombolysis and subsequent surgical revascularization as a graft salvage procedure is discussed. Four of 5 cases (80%) were successful in re-establishing flow and uncovering underlying arterial anatomic defects. None were treated definitively by endoluminal measures due to an inability to resolve the underlying anatomic defects. However, 2 of 5 cases (40%) went on to a successful surgical revascularization and represent successful long-term outcome of transcatheter thrombolysis followed by definitive surgical revascularization. We conclude that, definitive endoluminal success cannot be achieved without resolving associated, and possibly instigating, underlying arterial anatomical defects. However, reestablishing flow to the graft can unmask underlying lesions as well as asses surrounding vasculature thus providing anatomical information for a more elective, better planned and definitive surgical revision.

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Identifikatorlar

DOI: 10.1177/1538574406296210

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