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SIR 2025

Transplant Interventions

Scientific Session

Session: Transplant Interventions

Primary Patency and Duplex Ultrasound Dynamics in Drug-Eluting versus Bare-Metal Hepatic Artery Stents Placed in Liver Transplant Patients

Tuesday, April 1, 2025
3:36 PM – 3:45 PM CT
Location: Music City Center, 202 A
Purpose: To retrospectively analyze overall primary hepatic artery stent patency and compare the peak systolic velocity (PSV) and average resistive index (RI) via duplex ultrasound (US) in liver transplant patients who underwent hepatic artery intervention with drug-eluting stent (DES) versus bare metal stent (BMS).

Materials and Methods: From 2019 to 2024, 16 liver transplant patients (50 ± 18 years, 11/16 male) underwent hepatic artery stenting with either DES (6/16) or BMS (10/16). Primary patency was determined as the percentage of patients who did not require any interventions or experience a censored event (death, re-transplant, or surgical revision). Secondary patency was determined as the percentage of patients who did not require interventions on the placed stent. Serial duplex US imaging was performed immediately prior to stent placement, immediately after stent placement, and 3-6 months after stent placement. PSV was evaluated at the arterial anastomosis and a combined average RI was calculated from an average of the intrahepatic RIs from the left and right hepatic arteries. Results were compared to baseline using a student’s t-test to determine statistical significance.

Results: The mean follow-up interval was 11.4 months, with overall primary patency rate of 69% and secondary patency of 100%. Primary patency was 67% for DES and 60% for BMS. Overall average stent diameter 5.3mm. Average DES diameter was 4.3mm while the average BMS diameter was 5.8mm, P=0.0008. Average baseline PSV and RI were not different between DES and BMS (p=0.18 & p=0.22, respectively). Immediately post-stenting, PSV was significantly improved from baseline for DES (p=0.05), while it was not for BMS (p=0.13). RI was not changed from baseline for DES or BMS (p=0.06 and p= 0.38, respectively). After 3-6 months, PSV for DES remained significantly improved compared to baseline prior to intervention (p=0.02), while PSV for BMS was not improved (p=0.31). Average RI trended toward improvement in the DES group (0.59 from 0.38, p=0.10) but not in the BMS group (0.48 from 0.474 p=0.45) although not statistically significant.

Conclusion:

Despite the small sample size, there was good overall primary and secondary patency. Also, there was a statistically significant improvement in PSV with a trend towards improvement in RI at 3-6 months in liver transplant patients who underwent hepatic artery stenting with DES compared to BMS.