Saad Wael E A, Davies Mark G, Saad Nael E A, Westesson Karin E, Patel Nikhil C, Sahler Lawrence G, Lee David E, Kitanosono Takashi, Sasson Talia, Waldman David L
Department of Imaging Sciences, Section of Vascular/Interventional Radiology, University of Rochester Medical Center, 601 Elmwood Avenue, New York, NY 14642, USA.
Vasc Endovascular Surg. 2007 Feb-Mar;41(1):19-26. doi: 10.1177/1538574406296210.
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.
肝动脉血栓形成是肝移植中一种少见的并发症。然而，它是再次移植的主要指征。本文讨论了采用经导管溶栓及随后的外科血管重建作为一种移植物挽救方法。5例患者中有4例（80%）成功重建血流并发现潜在的动脉解剖缺陷。由于无法解决潜在的解剖缺陷，无一例通过腔内措施得到最终治疗。然而，5例患者中有2例（40%）成功进行了外科血管重建，代表了经导管溶栓后行确定性外科血管重建的成功长期结果。我们得出结论，若不解决相关的、可能是诱发因素的潜在动脉解剖缺陷，就无法实现确定性腔内成功。然而，恢复移植物血流可暴露潜在病变并评估周围血管系统，从而为更选择性、计划更周密的确定性外科修复提供解剖学信息。
