Safety and Efficacy of Primary Stent Placement for Hepatic Artery Kinks in Liver Transplant Recipients.

PURPOSE

To evaluate the long-term outcomes of primary stent placement for hepatic artery kinks in liver transplant recipients.

METHODS

After institutional review board approval, all patients undergoing liver transplantation between February 2001 and February 2024 at a single institution who underwent primary stent placement were reviewed. Patients who had hepatic artery thrombosis or underwent balloon angioplasty alone were excluded. Patients who underwent stent placement for hepatic artery kink were included. Hepatic artery kinks were defined by an acute arterial bend with coaptation of the arterial wall which is typically due to redundancy of the transplant hepatic artery. Hepatic arterial patency was evaluated at 1, 3, and 5 years. Kaplan-Meier analysis was performed for primary patency.

RESULTS

Fifty-six patients underwent hepatic artery stent placement. Further stratification resulted in 15/56 patients undergoing stent placement for hepatic artery kink. Primary patency rates for hepatic artery kink patients (n = 15) at 1, 3, and 5 years were 92%, 92%, and 92%, respectively. Primary-assisted patency for stent placement for hepatic artery kink was 100% at 1, 3, and 5 years. One patient had mid-stent kinking which was categorized as a technical failure and required re-intervention (n = 1/15). No patients had kink propagation or arterial rupture.

CONCLUSION

In conclusion, primary stent placement for hepatic artery kink has excellent long-term patency.