Abstract | PURPOSE: MATERIALS AND METHODS: We studied 24 consecutive patients suspected of having hepatic venous outflow obstruction after LDLT. Pressure gradients were measured proximal and distal to the lesion, and gradient values >3 mmHg were considered hemodynamically significant. We evaluated the technical success, complications, outcome of venoplasty and recurrence, and the patency rate. RESULTS: In all, 11 female patients manifested a pressure gradient >3 mmHg across the anastomotic site; they underwent subsequent PVT. The initial balloon venoplasty procedure was technically successful in 10 of the 11 patients (91%), and the pressure gradient was reduced from 5.8 to 1.1 mmHg (P < 0.01). Clinical improvement was observed in 9 of these 10 patients; one patient failed to improve and underwent retransplantation. Recurrent obstruction occurred in four patients; they underwent PTV with (n = 2) or without (n = 2) stent placement. There were no major procedural complications. CONCLUSION: PTV following venous pressure measurement is an effective and safe treatment for venous outflow obstruction in patients subjected to LDLT. In patients with recurrent obstruction, re-venoplasty is recommended.
|
Authors | Osamu Ikeda, Yoshitaka Tamura, Yutaka Nakasone, Yasuyuki Yamashita, Hideaki Okajima, Katsuhiro Asonuma, Yukihiro Inomata |
Journal | Japanese journal of radiology
(Jpn J Radiol)
Vol. 28
Issue 7
Pg. 520-6
(Aug 2010)
ISSN: 1867-108X [Electronic] Japan |
PMID | 20799017
(Publication Type: Journal Article)
|
Topics |
- Adolescent
- Adult
- Angiography
- Budd-Chiari Syndrome
(diagnostic imaging, etiology, therapy)
- Catheterization
(methods)
- Child
- Child, Preschool
- Female
- Fluoroscopy
- Humans
- Infant
- Liver Transplantation
(methods)
- Living Donors
- Middle Aged
- Recurrence
- Retrospective Studies
- Treatment Outcome
- Vascular Patency
- Venous Pressure
|