title: Angioplasty using covered stents in five patients with symptomatic pulmonary artery stenosis after single-lung transplantation.
abstract: OBJECTIVE
  After lung transplantation, pulmonary artery stenosis (PAS) may occur at the anastomotic site, resulting in poor graft function and hypoxemia. Surgical repair has been the standard-of-care, although percutaneous angioplasty with stent insertion has been performed in patients unsuitable for surgery. We summarize our experience of pulmonary artery stent-graft placement in transplant recipients who were also fit for surgical repair.
  
  
  METHODS
  Retrospective review of five cases of single-lung transplant recipients (4 male, 1 female, median age 61 years) who underwent percutaneous angioplasty and insertion of stent-graft for severe PAS. Balloon-expandable stent-grafts were used that were tailored to the donor and recipient vessel diameters.
  
  
  RESULTS
  Stenosis was diagnosed with computed tomography angiography at a median of 44 days (range 22-84) after transplantation. All stent placements were technically successful. There was only one periprocedural complication, a haemothorax that was drained. In four patients, the angioplasty improved the lung function; relative graft perfusion (as assessed by quantitative lung scintigraphy) improved by 26 % (IQR 13-37); and SpO2 improved by 8 % (IQR 4-9).
  
  
  CONCLUSIONS
  Percutaneous angioplasty using stent-graft is a minimally invasive, safe, and efficacious procedure for treatment of posttransplantation PAS and should be considered as an alternative to surgery even when the patient is considered fit for surgical repair.
authors: Department of Diagnostic Radiology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel, ahuvag@clalit.org.il.
authors: Ahuva
authors: A
authors: Grubstein
authors: Eli
authors: E
authors: Atar
authors: Sergey
authors: S
authors: Litvin
authors: Alexander
authors: A
authors: Belenky
authors: Michael
authors: M
authors: Knizhnik
authors: Benjamin
authors: B
authors: Medalion
authors: Yael
authors: Y
authors: Raviv
authors: Mordechai R
authors: MR
authors: Kramer
authors: Benjamin D
authors: BD
authors: Fox
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D011651:Pulmonary Artery / Q000473:pathology*; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome