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

Tuesday, April 1, 2025

3:45 PM – 3:54 PM CT

Location: Music City Center, 202 A

Presenting Author(s)

Sheikh Muhammad Usman Shami, MD (he/him/his)

Research Fellow
Beth Israel Deaconess Medical Center, United States

Author/Co-author(s)

Vijay Ramalingam, MD

Vascular Interventional Radiologist
Beth Israel Deaconess Medical Center, United States
Ammar Sarwar, MD, FSIR (he/him/his)

Associate Professor of Radiology
Beth Israel Deaconess Medical Center, United States
Jeffrey Weinstein, MD, FSIR

Assistant Professor of Radiology
Beth Israel Deaconess Medical Center, United States
DL

David Lee, MD

Associate Professor of Surgery
Beth Israel Deaconess Medical Center, United States
MC

Michael Curry, MD

Associate Professor
Beth Israel Deaconess Medical Center | Harvard Medical School, United States
DE

Devin E. Eckhoff, MD

Chief of Transplant Surgery
Beth Israel Deaconess Medical Center, United States
MA

Muneeb Ahmed, MD, FSIR

Professor of Radiology
Beth Israel Deaconess Medical Center/Harvard, United States

Purpose:

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

Materials and 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 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. Patients who had hepatic artery thrombosis or underwent balloon angioplasty alone were excluded. Hepatic arterial patency was evaluated at 1, 3 and 5 years. Kaplan-Meyer analysis was performed for primary patency.

Results:

56 patients underwent hepatic artery stent placement. Further stratification resulted in 15/56 patients undergoing stent placement for hepatic artery kink.

Primary patency rates were 89%, 85% and 85% at 1, 3 and 5 years, respectively for all patients without kink who received a stent (n = 41). Primary patency rates for hepatic artery kink patients (n= 15) at 1, 3, and 5 years were 92%, 92%, and 92% respectively (p = 0.5). Primary assisted patency in the kink group was 93% compared to 87% in the no kink group % at 1, 3, 5 years (p = 0.54).

One patient had mid-stent kinking which was categorized as a technical failure. No patients had kink propagation or arterial rupture.

Conclusion:

In conclusion, primary stent placement for hepatic artery kink has excellent long-term patency with no difference in primary patency for hepatic artery stenting for other causes of hepatic artery stent placement.