title: Endovascular management of early lung transplant-related anastomotic pulmonary artery stenosis.
abstract: OBJECTIVE
  To report the safety and short-term efficacy of endovascular interventions for symptomatic lung transplant-related anastomotic pulmonary artery stenosis (PAS).
  
  
  METHODS
  From February 2008 to December 2011, 354 lung transplants were performed. Pulmonary arteriography was performed in 19 patients (63% men; age, 57 y ± 21, mean ± SD; seven double-lung transplants) because of respiratory decompensation (mean 6.7 mo after transplant). Seven arteriograms were normal, and 12 showed significant PAS. One patient (5%) underwent angioplasty alone, and 11 patients (57%) underwent stent placement.
  
  
  RESULTS
  All patients underwent general anesthesia, and femoral access was used for the intervention. Technical success was 100% in the 12 patients treated. Symptoms improved in all patients who underwent intervention, with resolution in 11 of 12 (92%). There were no major or minor complications. Three patients (16%) had recurrent symptoms after discharge secondary to chronic rejection or pneumonia. Two patients died as a result of sepsis and multiorgan failure at 2 days and 14 days, respectively, after undergoing only pulmonary arteriography. In-stent stenosis occurred in 1 (9%) patient who required additional stent placement. During a mean follow-up period of 11 months, the remaining stents were patent, and the patients were asymptomatic.
  
  
  CONCLUSIONS
  Endovascular stent placement provides an alternative to open repair for transplant-related anastomotic PAS. It has low mortality and morbidity rates, and it has shown excellent short-term functional and anatomic outcomes.
authors: Department of Cardiovascular Surgery, Houston Methodist Hospital, 6550 Fannin Street, Houston, TX 77030.. Electronic address: MDavies@houstonmethodist.org.
authors: Javier E
authors: JE
authors: Anaya-Ayala
authors: Department of Cardiovascular Surgery, Houston Methodist Hospital, 6550 Fannin Street, Houston, TX 77030.
authors: Matthias
authors: M
authors: Loebe
authors: Department of Cardiovascular Surgery, Houston Methodist Hospital, 6550 Fannin Street, Houston, TX 77030.
authors: Mark G
authors: MG
authors: Davies
mesh_terms: D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013781:Texas; D013997:Time Factors; D016896:Treatment Outcome