THROMBOLYSIS AND ENDOVASCULAR STENT PLACEMENT FOR INFERIOR VENA CAVAL THROMBOSIS IN A LIVER TRANSPLANT RECIPIENT
作者:
Orons1,2 Philip,
Hari3 Anil,
Zajko1 Albert,
Marsh4 J.,
期刊:
Transplantation
(OVID Available online 1997)
卷期:
Volume 64,
issue 9
页码: 1357-1361
ISSN:0041-1337
年代: 1997
出版商: OVID
数据来源: OVID
摘要:
Background.Vascular complications remain an important cause of postoperative morbidity in liver transplant patients. Herein, we present an unusual case of nonanastomotic inferior vena cava (IVC) stenosis in a patient with a“piggyback” caval anastomosis.Methods.A 59-year-old woman underwent liver transplantation using a piggyback IVC anastomosis. Her postoperative course was complicated by IVC thrombosis. Catheter-directed thrombolysis, followed by balloon angioplasty and intravascular stent placement, was used to recanalize the IVC and treat a severe retrohepatic IVC stenosis.Results.After 46 hr of catheter-directed urokinase infusion, there was clot lysis and identification of a severe stenosis in the retrohepatic IVC. The lesion was extremely resistant to balloon dilatation alone and a 22-mm-diameter intravascular stent was placed. Simultaneous dilatation of three high-pressure balloons was necessary for maximal stent expansion. The patient remains asymptomatic with no evidence of IVC compromise through 20 months of follow-up.Conclusions.IVC stenosis and thrombosis after liver transplantation may be treated favorably in some patients using catheter-directed thrombolytic therapy followed by balloon dilatation and/or stent placement.
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