肝移植术后肝动脉狭窄和血栓形成的血管内治疗
Endovascular therapy for hepatic artery stenosis and thrombosis following liver transplantation.
作者信息
Sabri Saher S, Saad Wael E A, Schmitt Timothy M, Turba Ulku C, Kumer Sean C, Park Auh-Whan, Matsumoto Alan H, Angle John F
机构信息
Division of Vascular and Interventional Radiology, Department of Radiology, University of Virginia Health System, Charlottesville, VA, USA.
出版信息
Vasc Endovascular Surg. 2011 Jul;45(5):447-52. doi: 10.1177/1538574411407088. Epub 2011 May 13.
PURPOSE
To evaluate the effectiveness of endovascular management of steno-oclusive disease in liver transplants.
METHODS
Retrospective review of liver transplant recipients with hepatic artery stenosis (HAS) or thrombosis (HAT) was performed. The HAS group was treated with balloon angioplasty with selective stent placement. The HAT group was treated with catheter-directed thrombolysis. Primary, unassisted, and assisted patency and graft survival rates were calculated.
RESULTS
In all, 31 patients were identified (21 males; mean age, 51 years). A total of 25 of 31 (81%) patients had HAS and 6 of 31 (19%) had HAT. Collectively, a total of 35 endovascular procedures were performed to treat HAS in 25 patients. Overall technical success rate was 91%, with 11% major complication rate. Primary-assisted patency rate and graft survival at 6 and 12 months were 87% and 81%, and 76% and 72%, respectively. Only 1 successful thrombolysis of HAT was achieved.
CONCLUSION
Endovascular management is effective for HAS but not for HAT.
目的
评估肝移植中狭窄闭塞性疾病的血管内治疗效果。
方法
对肝动脉狭窄（HAS）或血栓形成（HAT）的肝移植受者进行回顾性研究。HAS组采用球囊血管成形术并选择性置入支架治疗。HAT组采用导管直接溶栓治疗。计算一期通畅率、无辅助通畅率、辅助通畅率及移植物生存率。
结果
共纳入31例患者（21例男性；平均年龄51岁）。31例患者中，25例（81%）有HAS，6例（19%）有HAT。25例HAS患者共进行了35次血管内治疗。总体技术成功率为91%，主要并发症发生率为11%。6个月和12个月时的一期辅助通畅率及移植物生存率分别为87%和81%，76%和72%。HAT仅成功溶栓1例。
结论
血管内治疗对HAS有效，但对HAT无效。
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