Paclitaxel coated-stent for early-onset thrombosis after liver transplantation.
Hepatic artery thrombosis (HAT) is the most common vascular complication of orthotopic liver transplantation (OLT) and constitutes a potential emergency during the postoperative period. Surgical revascularization and retransplantation are the treatments of choice for this condition. The aim of this report is to present long-term follow-up on survival and graft function of three patients with paclitaxel-coated hepatic artery stents placed percutaneously after earlyonset HAT. Three patients developed early onset HAT after cadaveric-donor OLT in a tertiary care center in Mexico. These patients were treated percutaneously with balloon angioplasty and paclitaxel-coated stents. After 24 months or more of follow-up, 2 patients present total occlusion of the stent and one patient, intra-stent stenosis; interestingly, all patients have normal graft function and excellent quality of life. In conclusion, although balloon angioplasty and stent placement may be a therapeutic option for suitable patients with early-onset HAT after OLT, longterm patency is unlikely even with the use of paclitaxel- coated materials.
Reyes-Corona
Jesus
J
Department of Hemodynamics and Interventional Cardiology, ISSMYM Medical Center, Metepec, Mexico. reyescorona@yahoo.com
Gonzalez-Huezo
María S
MS
Zea-Medina
María V
MV
Zamora-Valdés
Daniel
D
Victoria-Campos
José L
JL
Mondragon-Sanchez
Ricardo J
RJ
D000328:Adult; D000800:Angioplasty, Balloon; D001241:Aspirin / Q000494:pharmacology; D000077144:Clopidogrel; D054855:Drug-Eluting Stents; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008800:Mexico; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D013927:Thrombosis / Q000209:etiology / Q000628:therapy*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000494:pharmacology; D050257:Tubulin Modulators / Q000494:pharmacology*; D014656:Vascular Surgical Procedures
D010975:Platelet Aggregation Inhibitors; D050257:Tubulin Modulators; D000077144:Clopidogrel; D013988:Ticlopidine; D017239:Paclitaxel; D001241:Aspirin