Endovascular Management of Thrombosed Cavoportal Anastomosis After Liver Transplantation Using Catheter Directed Thrombolysis and Stent Placement: A Case Report.

Transplantation proceedings Pub Date : 2024-10-22 DOI:10.1016/j.transproceed.2024.10.021

Lawrence Bonne, Hannah Van Malenstein, Peter Verhamme, Diethard Monbaliu, Chris Verslype, Mauricio Sainz Barriga, Schalk Van der Merwe, Thomas Vanassche, Jacques Pirenne, Geert Maleux

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Abstract

Cavoportal hemitransposition (CPHT) is a rarely performed treatment technique in liver transplantation in cases of extensive splanchnic thrombosis, in which the inferior vena cava of the recipient is used to perfuse the portal vein of the allograft. A case of a 65-year-old liver transplantation patient with an acutely thrombosed cavoportal anastomosis is presented. After unsuccessful medical treatment, recanalization was obtained with transfemoral catheter directed thrombolysis, angioplasty and stent placement. Although this type of treatment has been extensively documented for the management of portal anastomotic problems after orthotopic liver transplantation, data on its application in modified transplantation techniques including CPHT are rare. This technique provides a minimally invasive treatment option in CPHT patients with cavoportal anastomotic problems, who might otherwise require complex surgical repair or retransplantation.

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肝移植后腔静脉吻合口血栓形成的血管内治疗--导管引导溶栓和支架植入：病例报告。

腔门吻合术（Cavoportal hemitransposition，CPHT）是肝移植手术中一种罕见的治疗技术，适用于脾脏广泛血栓形成的病例，即利用受体的下腔静脉灌注同种异体肝移植的门静脉。本报告介绍了一例 65 岁的肝移植患者，其腔门吻合口急性血栓形成。在药物治疗未果后，患者通过经股导管定向溶栓、血管成形术和支架置入获得了再通路。虽然这种治疗方法已被广泛用于治疗正位肝移植后的门静脉吻合问题，但将其应用于包括 CPHT 在内的改良移植技术的数据却非常罕见。这项技术为有腔门吻合问题的 CPHT 患者提供了一种微创治疗选择，否则这些患者可能需要进行复杂的手术修复或再次移植。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Transplantation proceedings

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