title: Pancreas transplants venous graft thrombosis: endovascular thrombolysis for graft rescue.
abstract: OBJECTIVE
  To retrospectively assess the efficacy and safety of percutaneous endovascular treatment in patients with pancreas venous graft thrombosis (PVGT).
  
  
  METHODS
  Between 2001 and 2009, 206 pancreas transplants were performed at our institution. A retrospective review of pancreas graft recipients who underwent endovascular therapy for PVGT was performed. The study group included 17 patients (10 men, 7 women; mean age 38 years) with PVGT (<60 % [9 patients]; 30-60 % [8 patients]) 6.6 ± 5.7 days after grafting. The angiographic studies, type of endovascular procedure, endovascular procedural and postprocedural effectiveness, and patient and graft outcomes were assessed.
  
  
  RESULTS
  In 16 of 17 cases (94 %), significant (87.5 %) or partial (12.5 %) lysis of thrombi was achieved. One patient had external compression of the portal vein due to a hematoma, which hindered mechanical removal of the thrombi. This patient required graft pancreatectomy for extensive areas of parenchymal necrosis 2 days after the endovascular procedure. No complications related to endovascular treatment were observed. Postprocedural bleeding episodes related to anticoagulation were observed in five patients. Patient and pancreas graft survival rates at 12 months were 94 and 76 %, respectively.
  
  
  CONCLUSIONS
  Catheter-directed thrombectomy is an effective treatment for patients with PVGT. Percutaneous thrombectomy, followed by anticoagulation, appears to be an effective therapy to remove the thrombus and is associated with a low complication rate.
authors.affiliation: Diagnostic Imaging Center, Hospital Clinic University of Barcelona, Villarroel 170 , 08036, Barcelona, Spain, barrufet@clinic.ub.es.
authors.forename: Marta
authors.initials: M
authors.lastname: Barrufet
authors.forename: Marta
authors.initials: M
authors.lastname: Burrel
authors.forename: M
authors.initials: M
authors.lastname: Angeles García-Criado
authors.forename: Xavier
authors.initials: X
authors.lastname: Montañà
authors.forename: M I
authors.initials: MI
authors.lastname: Real
authors.forename: Joana
authors.initials: J
authors.lastname: Ferrer
authors.forename: Laureano
authors.initials: L
authors.lastname: Fernández-Cruz
authors.forename: Rosa
authors.initials: R
authors.lastname: Gilabert
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D017131:Thrombectomy / Q000379:methods*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000601:surgery*; D055815:Young Adult