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Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure
Published on: September 13, 2014
12.7K
Hepatic artery stenting with Viabahn
Kenichiro Okumura1, Takahiro Ogi2, Junichi Matsumoto1
1Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan.
CVIR Endovascular
|December 19, 2024
Summary
Vessel tortuosity and distal narrowing impact Viabahn stent-graft success in treating arterial bleeding after surgery. Careful management is needed to avoid complications like stent occlusion.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Hepatobiliary Surgery
Background:
- Vessel morphology's impact on Viabahn stent-graft outcomes for postoperative arterial injuries and bleeding (AIB) after hepatopancreatobiliary surgery is unclear.
- Stiff guidewires are used to navigate tortuous vessels, but stent insertion challenges persist.
Purpose of the Study:
- To identify vessel morphologies associated with technical success and short-term patency of Viabahn stent-grafts.
- To explore effective management strategies for these challenging cases.
Main Methods:
- Retrospective review of 12 consecutive hepatic artery stenting cases using Viabahn grafts for AIB (2017-2024).
- Evaluation of vessel tortuosity and narrowing, guidewire use, and stent placement details.
- Assessment of technical/clinical success and one-month stent patency.
Main Results:
- 100% technical and clinical success was achieved in all cases.
- Vessel tortuosity created "accordion-like" appearances and steps, complicating stent insertion (p=0.005).
- One-month stent patency was 83% (10/12 cases). Severe distal narrowing increased stent occlusion risk (67% vs. <33%, p=0.045), particularly with overlapping grafts.
Conclusions:
- "Accordion-like" appearances from tortuous hepatic arteries complicate stent insertion.
- Severe distal vessel narrowing significantly elevates the risk of short-term stent occlusion.
