Catheter thrombolysis of thrombosed hepatic arteries in liver transplant recipients: Predictors of success and role of thrombolysis

Wael E.A. Saad, Mark G. Davies, Nael E.A. Saad, Karin E. Westesson, Nikhil C. Patel, Lawrence G. Sahler, David E. Lee, Takashi Kitanosono, Talia Sasson, David L. Waldman

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)19-26
Number of pages8
JournalVascular and Endovascular Surgery
Volume41
Issue number1
DOIs
StatePublished - Feb 1 2007
Externally publishedYes

Keywords

  • Angioplasty
  • Hepatic artery
  • Liver transplant
  • Stenosis
  • Thrombolysis
  • Thrombosis

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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