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Angioplasty Using Covered Stents in Five Patients With Symptomatic Pulmonary Artery Stenosis After Single-Lung Transplantation

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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.

Materials and 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).

Conclusion

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.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel

    Ahuva Grubstein

  2. Department of Interventional Radiology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel

    Eli Atar, Sergey Litvin, Alexander Belenky & Michael Knizhnik

  3. Department of Cardiothoracic Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel

    Benjamin Medalion

  4. Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petach Tikva, 49100, Israel

    Yael Raviv, Mordechai R. Kramer & Benjamin D. Fox

  5. Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Ahuva Grubstein, Eli Atar, Sergey Litvin, Alexander Belenky, Michael Knizhnik, Benjamin Medalion, Yael Raviv, Mordechai R. Kramer & Benjamin D. Fox

Authors
  1. Ahuva Grubstein
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  2. Eli Atar
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  3. Sergey Litvin
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  4. Alexander Belenky
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  5. Michael Knizhnik
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  6. Benjamin Medalion
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  7. Yael Raviv
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  8. Mordechai R. Kramer
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  9. Benjamin D. Fox
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Corresponding author

Correspondence to Mordechai R. Kramer.

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Grubstein, A., Atar, E., Litvin, S. et al. Angioplasty Using Covered Stents in Five Patients With Symptomatic Pulmonary Artery Stenosis After Single-Lung Transplantation. Cardiovasc Intervent Radiol 37, 686–690 (2014). https://doi.org/10.1007/s00270-013-0758-0

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  • DOI: https://doi.org/10.1007/s00270-013-0758-0

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