title: Ultrasound-accelerated, catheter-directed thrombolysis for inferior vena cava thrombosis after an orthotopic liver transplant.
abstract: Inferior vena cava thrombosis is a rare occurrence after an orthotopic liver transplant that is associated with a high rate of retransplant and mortality. There is no consensus regarding the optimal therapeutic strategy. Surgical management, including thrombectomy with revision of the cavocaval anastomosis, has been described. With the use of endovascular therapies, several minimally invasive approaches are available that are effective and avoid the high morbidity associated with reoperative surgery. We describe our successful experience using an approach after a liver transplant in which the inferior vena cava thrombosis in a patient presenting with acute renal failure, anorexia, weight loss, and fatigue using an ultrasound-accelerated, catheter-directed thrombolysis platform in conjunction with systemic anticoagulation.
authors.affiliation: From the Department of Surgery, Division of Transplantation, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Latchana
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Dowell
authors.forename: Jamal
authors.initials: J
authors.lastname: Al Taani
authors.forename: Anthony
authors.initials: A
authors.lastname: Michaels
authors.forename: Elmadhi
authors.initials: E
authors.lastname: Elkhammas
authors.forename: Sylvester M
authors.initials: SM
authors.lastname: Black
mesh_terms: D015901:Angiography, Digital Subtraction; D000925:Anticoagulants / Q000627:therapeutic use; D002406:Catheterization, Peripheral; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007262:Infusions, Intravenous; D008108:Liver Diseases, Alcoholic / Q000150:complications / Q000175:diagnosis; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D015641:Radiography, Interventional; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014464:Ultrasonic Therapy; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents