Hepatic artery stenosis after liver transplantation may affect liver function and result in hepatic artery thrombosis.
Surgical reconstruction has been the first choice for treatment.
Interventional radiologic technique can be used, but there is no report on long-term outcome.
Dr Goran Klintmalm and colleagues from Texas assessed current outcome and complications of hepatic artery stenting.
The investigative team stented 26 adult patients for hepatic artery stenosis between 1998 and 2003.
The team reported that 9 patients had previous surgical reconstruction for hepatic artery stenosis, and 17 patients suffered newly developed hepatic artery stenosis.
The team noted that 3 patients were retransplanted.
After stenting, the patients were followed by Doppler ultrasound at day 1, 1 month, and 6 months.
|Complication-free survival was 54% at 1 year after stenting|
Angiography was scheduled in 6 months, however 4 patients died within 2 months.
The investigators followed 22 patients for a mean of 31 months.
The team noted that 1 patient died from renal failure 2 years later.
The hepatic arteries looked normal in 12 patients after stenting, however, restenosis was seen in 8 patients.
Other complications observed were artery thrombosis, and long segment stricture.
The investigators noted that in 2 patients, restenosis resulted in thrombosis.
The investigative team observed that 6 of the 8 patients who developed recurrent stenosis were successfully treated by restent, and balloon dilation.
However, 3 patients restenosed.
Kaplan-Meier complication-free survival was 54% at 1 year after stenting.
Dr Klintmalm's team concludes, “Hepatic artery stenting is a viable treatment for hepatic artery stenosis with reasonable results.”
“Stenting is useful as adjuvant treatment after surgical revision.”