Estenose arterial pos-transplante hepatico: tratamento com angioplastia transluminal percutanea



Document title: Estenose arterial pos-transplante hepatico: tratamento com angioplastia transluminal percutanea
Journal: Revista do Colegio Brasileiro de Cirurgioes
Database: PERIÓDICA
System number: 000141423
ISSN: 0100-6991
Authors: 1




Institutions: 1Hospital Sao Camilo, Sao Paulo. Brasil
Year:
Season: May-Jun
Volumen: 25
Number: 3
Pages: 214-216
Country: Brasil
Language: Portugués
Document type: Artículo
Approach: Caso clínico
English abstract Vascular complications after liver transplantation include oclusion or stenosis at the sites of anastomosis in the hepatic artery, portal vein, and vena cava. Balloon angioplasty of these stenosis carries little risk and is a useful procedure for the treatment of these problems. The purpose of this paper was to assess whether percutaneous transluminal angioplasty can help to prolong allograft survival and impruve allograft function in patient with hepatic artery stenosis after liver transplantation. We report a 43-year-old mate with stenosis of hepatic artery anastomosis after liver transplantation. An abrupt elevation of liver enzymes and serum bilirrubin levels was noted on the fifth postoperative month. The patient underwent percutaneous liver biopsy, which revealed important ductal depletion due to hypoperfusion, even though Doppler ultrasound examination demonstrated arterial flow. An angiogram confirmed severe stenosis of the arterial anastomosis with poor intraparenchymal arterial perfusion pattern. In an attempt to preserve the graft, a percutaneous transluminal angioplasty was performed using microballoons mounted on a hydrophylic micro guidewire. Intervention proceeded without complications. Liver enzimes and bilirrubin levels decreased within twenty-four hours of angioplasty. Normal levels were achieved after one week. Seven month after angioplasty, the patient is in a optimal clinical condition with no signs of graft impairment. We conclude that percutaneous transluminal angioplasty of hepatic artery stenosis after liver transplantation is relatively safe and may help decrease allograft loss
Disciplines: Medicina
Keyword: Cirugía,
Gastroenterología,
Estenosis,
Arteria hepática,
Hígado,
Trasplantes
Keyword: Medicine,
Gastroenterology,
Surgery,
Stenosis,
Hepatic artery,
Liver,
Transplantation
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