Huang Ming-sheng, Jiang Zai-bo, Zhu Kang-shun, Guan Shou-hai, Li Hua, Yang Yang, Chen Gui-hua, Shan Hong
Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
Zhonghua Yi Xue Za Zhi. 2008 Aug 12;88(31):2175-8.
To evaluate the long-term clinical outcomes and complications of coronary stent placement for hepatic artery stenosis (HAS) after orthotopic liver transplantation (OLT) retrospectively.
Eighteen of the 26 patients with HAS or hepatic artery thrombosis confirmed by digital subtraction angiography underwent hepatic artery stenting with coaxial catheter technique and then followed up for 21.7 months (2.3 - 37.2 months). Liver function tests, color Doppler ultrasonography and CT angiography were conducted.
Three patients died and 1 patient underwent re-transplantation within 2 months after stenting procedure. Seven patients' hepatic arteries looked normal after stenting. Restenosis was seen in 4 patients (28.5%). Two of them needed re-transplantation 20.5 and 5.1 months after stenting respectively. Three patients died of septic multiple-organ failure, liver abscess, and biliary infection respectively though their hepatic arteries were patent. Kaplan-Meier curve showed that the 1-, 2-, and 3-year survival rates were 76%, 76%, and 76% respectively, and the 1-, 2-, and 3-year graft survival rates after stenting were 69.5%, 69.5%, and 48.0% respectively, and the primary hepatic artery patency rates were 63%, 63%, and 63% respectively.
HAS after OLT can be successfully treated with stent placement with an acceptable 1-, 2- and 3-year patient, graft survival and primary stent patency rates.
回顾性评估原位肝移植(OLT)后肝动脉狭窄(HAS)患者冠状动脉支架置入术的长期临床疗效和并发症。
26例经数字减影血管造影证实为HAS或肝动脉血栓形成的患者中,18例采用同轴导管技术行肝动脉支架置入术,随后随访21.7个月(2.3 - 37.2个月)。进行肝功能检查、彩色多普勒超声检查和CT血管造影。
3例患者在支架置入术后2个月内死亡,1例患者接受了再次移植。7例患者支架置入术后肝动脉外观正常。4例患者(28.5%)出现再狭窄。其中2例分别在支架置入术后20.5个月和5.1个月需要再次移植。3例患者尽管肝动脉通畅,但分别死于感染性多器官功能衰竭、肝脓肿和胆道感染。Kaplan-Meier曲线显示,1年、2年和3年生存率分别为76%、76%和76%,支架置入术后1年、2年和3年移植物生存率分别为69.5%﹑69.5%和48.0%,肝动脉初始通畅率分别为63%、63%和63%。
OLT术后的HAS通过支架置入术可得到成功治疗,患者1年、2年和3年生存率、移植物生存率及肝动脉初始通畅率均可接受。