Treatment of hepatic artery stenosis in liver transplant patients using drug-eluting versus bare-metal stents

Sailendra Naidu, Sadeer Alzubaidi, Grace Knuttinen, Indravadan Patel, Andrew Fleck, John Sweeney, Bashar Aqel, Brandon Larsen, Matthew Buras, Michael Golafshar, Rahmi Oklu

Research output: Contribution to journalArticlepeer-review

Abstract

Hepatic artery stenosis after liver transplant is often treated with endovascular stent placement. Our institution has adopted use of drug-eluting stents, particularly in small-caliber arteries. We aimed to compare patency rates of drug-eluting stents vs. traditional bare-metal stents. This was a single-institution, retrospective study of liver transplant hepatic artery stenosis treated with stents. Primary patency was defined as time from stent placement to resistive index on Doppler ultrasonography (<0.5), hepatic artery thrombosis, or any intervention including surgery. Fifty-two patients were treated with stents (31 men; mean age, 57 years): 15, drug-eluting stents; 37, bare-metal stents. Mean arterial diameters were 4.1 mm and 5.1 mm, respectively. Technical success was 100% (52/52). At 6 months, 1, 2, and 3 years, primary patency for drug-eluting stents was 80%, 71%, 71%, and 71%; bare-metal stents: 76%, 65%, 53%, and 46% (p = 0.41). Primary patency for small-caliber arteries (3.5–4.5 mm) with drug-eluting stents was 93%, 75%, 75%, and 75%; bare-metal stents: 60%, 60%, 50%, and 38% (p = 0.19). Overall survival was 100%, 100%, 94%, and 91%. Graft survival was 100%, 98%, 96%, and 90%. Stenting for hepatic artery stenosis was safe and effective. While not statistically significant, patency improved with drug-eluting stents compared with bare-metal stents, especially in arteries < 4.5 mm in diameter. Drug-eluting stents can be considered for liver transplant hepatic artery stenosis, particularly in small-caliber arteries.

Original languageEnglish (US)
Article number380
Pages (from-to)1-11
Number of pages11
JournalJournal of Clinical Medicine
Volume10
Issue number3
DOIs
StatePublished - Jan 2021

Keywords

  • Arterial occlusive diseases/therapy
  • Hepatic artery/physiopathology
  • Liver transplanta-tion/adverse effects
  • Stents
  • Vascular patency

ASJC Scopus subject areas

  • General Medicine

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