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Neuroform EZ Stents for Hepatic Artery Stenosis After Liver Transplantation: A Single-Center Preliminary Report

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  • Arterial Interventions
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Abstract

Purpose

This preliminary study evaluated the safety and effectiveness for off-label use of Neuroform EZ (NEZ) stents in the revascularization of hepatic artery stenosis (HAS) after orthotopic liver transplantation (OLT).

Materials and Methods

Nine of 489 (5%) OLTs with HAS were managed with NEZ stents between September 2016 and July 2021. Stenting outcomes were evaluated based on the technical success rate, procedure-related complications, and primary patency.

Results

A total of 10 NEZ stents (4.5 mm × 3 cm, n = 6; 4 mm × 3 cm, n = 4) were successfully deployed in 9 torturous hepatic arteries and in 1 relatively straight artery without any procedure-related complications. Combined thrombolysis (n = 3) and balloon angioplasty (n = 6) was performed. The median duration of follow-up was 438 days (range, 120–1126 days). Asymptomatic re-stenoses were detected in 2 stents on days 60 and 433 after stenting. A Kaplan–Meier curve predicted cumulative primary stent patencies at 1, 2, and 3 years of 90%, 75%, and 75%, respectively.

Conclusion

NEZ stents can be safely used to treat HAS after OLT with high technical success and favorable primary patency.

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References

  1. Yang Y, Li H, Fu BS, Zhang Q, Zhang YC, Lu MQ, et al. Hepatic artery complications after orthotopic liver transplantation: interventional treatment or retransplantation? Chin Med J (Engl). 2008;121(20):1997–2000.

    Article  Google Scholar 

  2. Maruzzelli L, Miraglia R, Caruso S, Milazzo M, Mamone G, Gruttadauria S, et al. Percutaneous endovascular treatment of hepatic artery stenosis in adult and pediatric patients after liver transplantation. Cardiovasc Intervent Radiol. 2010;33(6):1111–9.

    Article  Google Scholar 

  3. Ueno T, Jones G, Martin A, Ikegami T, Sanchez EQ, Chinnakotla S, et al. Clinical outcomes from hepatic artery stenting in liver transplantation. Liver Transpl. 2006;12(3):422–7.

    Article  Google Scholar 

  4. Hamby BA, Ramirez DE, Loss GE, Bazan HA, Smith TA, Bluth E, et al. Endovascular treatment of hepatic artery stenosis after liver transplantation. J Vasc Surg. 2013;57(4):1067–72.

    Article  Google Scholar 

  5. Denys AL, Qanadli SD, Durand F, Vilgrain V, Farges O, Belghiti J, et al. Feasibility and effectiveness of using coronary stents in the treatment of hepatic artery stenoses after orthotopic liver transplantation: preliminary report. AJR Am J Roentgenol. 2002;178(5):1175–9.

    Article  Google Scholar 

  6. Sarwar A, Chen C, Khwaja K, Malik R, Raven KE, Weinstein JL, et al. Primary stent placement for hepatic artery stenosis after liver transplantation: improving primary patency and reintervention rates. Liver Transpl. 2018;24(10):1377–83.

    Article  Google Scholar 

  7. Lesley WS, Patel DV. Neuroform-EZ stent modification for facilitated delivery during intracranial aneurysm embosurgery. Neurointervention. 2013;8(2):101–4.

    Article  Google Scholar 

  8. Du Z, Mang J, Yu S, Tian C, Cao X, Liu X, et al. Weighing in on the off-label use: initial experience of neuroform EZ stenting for intracranial arterial stenosis in 45 patients. Front Neurol. 2018;9:852.

    Article  Google Scholar 

  9. Breguet R, Dondero F, Pupulim L, Goossens N, Sepulveda A, Francoz C, et al. Endovascular treatment of arterial complications after liver transplantation: long-term follow-up evaluated on doppler ultrasound and magnetic resonance cholangiopancreatography. Cardiovasc Intervent Radiol. 2019;42(3):381–8.

    Article  Google Scholar 

  10. Boyvat F, Aytekin C, Harman A, Sevmis S, Karakayali H, Haberal M. Endovascular stent placement in patients with hepatic artery stenoses or thromboses after liver transplant. Transplant Proc. 2008;40(1):22–6.

    Article  CAS  Google Scholar 

  11. Rajakannu M, Awad S, Ciacio O, Pittau G, Adam R, Cunha AS, et al. Intention-to-treat analysis of percutaneous endovascular treatment of hepatic artery stenosis after orthotopic liver transplantation. Liver Transpl. 2016;22(7):923–33.

    Article  Google Scholar 

  12. Murray TÉ, Brennan P, Maingard JT, Chandra RV, Little DM, Brooks DM, et al. Treatment of visceral artery aneurysms using novel neurointerventional devices and techniques. J Vasc Interv Radiol. 2019;30(9):1407–17.

    Article  Google Scholar 

  13. Vajda Z, Güthe T, Aguilar-Perez M, Kurre W, Bäzner H, Henkes H. Prevention and treatment of neurovascular in-stent stenoses: review of the concepts. Expert Rev Cardiovasc Ther. 2013;11(4):463–8.

    Article  CAS  Google Scholar 

  14. Le L, Terral W, Zea N, Bazan HA, Smith TA, Loss GE, et al. Primary stent placement for hepatic artery stenosis after liver transplantation. J Vasc Surg. 2015;62(3):704–9.

    Article  Google Scholar 

  15. Goldsmith LE, Wiebke K, Seal J, Brinster C, Smith TA, Bazan HA, et al. Complications after endovascular treatment of hepatic artery stenosis after liver transplantation. J Vasc Surg. 2017;66(5):1488–96.

    Article  Google Scholar 

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Acknowledgements

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Interventional Radiology, Jiangsu Province Hospital (The First Affiliated Hospital of Nanjing Medical University), Guangzhou Road 300, Nanjing, 210029, China

    Ke Zhang & Jie Wang

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  1. Ke Zhang
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  2. Jie Wang
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Correspondence to Jie Wang.

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This retrospective study was approved by the local ethics committee. For this type of study, formal consent is not required.

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Zhang, K., Wang, J. Neuroform EZ Stents for Hepatic Artery Stenosis After Liver Transplantation: A Single-Center Preliminary Report. Cardiovasc Intervent Radiol 45, 852–857 (2022). https://doi.org/10.1007/s00270-022-03100-7

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  • DOI: https://doi.org/10.1007/s00270-022-03100-7

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