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SIR 2025
Transplant Interventions
Traditional Poster
Aniket N. Pandya, MD
Resident Physician
University of Massachusetts, United States
Alex Newbury, MD, MS (he/him/his)
Fellow Physician
University of Massachusetts, Beth Israel Deaconess Medical Center, United States
Baylee Wiechecki (she/her/hers)
Medical Student
Oregon Health and Science University, United States
James Palmer, MD
Resident Physician
Oregon Health and Science University, United States
Tomas Figueira, MD
Director of Interventional Oncology
Umass Memorial Medical Center, United States
John Kaufman, MD, FSIR, MS
Attending Physician
Dotter Interventional Institute, United States
Ningcheng (Peter) Li, MD, MS
Associate Program Director
Umass Chan Medical School, United States
To report the initial safety and effectiveness profile of drug-eluting stent (DES) placement for distal hepatic artery stenosis (HAS) after liver transplant in six patients at two high-volume tertiary care transplant centers.
Materials and Methods:
A retrospective chart review was performed at two tertiary care transplant centers on all patients with transplant HAS who underwent primary percutaneous trans-arterial DES placement. Six patients were identified (mean ± SD: 54.6 ± 11.6 years; 33% female). Patient demographics, procedural details, and follow-ups as well as pre- and post-procedural imaging were reviewed. The DES utilized included Synergy (Boston Scientific, Marlborough, MA) and Resolute (Medtronic, Minneapolis, MN).
Results:
All DES placement procedures in the setting of transplant HAS were performed after 2023. The median time from transplant to HAS diagnosis, and from HAS diagnosis to DES placement was 75 days, and 63 days, respectively. The HAS was 73.2 ± 24.8 mm from its parent vessel’s origin at the abdominal aorta, had a length of 19.2 ± 5.2 mm, and a luminal diameter of 1.4 ± 0.5 mm on angiography, constituting 67.8± 13.0 % stenosis.
Heparin was administered intra-procedurally for all cases. The utilized DES had a length of 33 ± 8 mm. The post-stent luminal diameter was 4.3 ± 0.5 mm, constituting 107.9 ± 52.9% recovery compared to the pre-stent diameter, and 69.6 ± 26.3% compared to the normal arterial diameter distal to the stenosis. No intra- or post-procedural adverse events were noted. Post-procedural medical therapies included aspirin, along with either Plavix or Eliquis.
During a median follow-up of 398 days, 5 patients (83%) had imaging demonstrating stent patency and 2 patients (33%) had complete normalization of liver function. No patients required secondary surgical revascularization.
Conclusion:
This six-patient case series of successful primary percutaneous trans-arterial DES placement from two tertiary care transplant centers highlighted the initial safety and effectiveness profile of the technique in treating distal severe HAS.