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Successful percutaneous transluminal angioplasty for hepatic artery stenosis in an infant undergoing living‐related liver transplantation
Author(s) -
Hasegawa Toshimichi,
Sasaki Takashi,
Kimura Takuya,
Okada Akira,
Nakatsuchi Yoshiaki,
Sugiura Takashi,
Kato Hiromi,
Nakajima Yoshikazu
Publication year - 2002
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1034/j.1399-3046.2002.01081.x
Subject(s) - medicine , stenosis , surgery , angioplasty , transplantation , percutaneous , liver transplantation , perforation , complication , artery , catheter , balloon catheter , biliary atresia , cardiology , radiology , punching , materials science , metallurgy
A 1‐yr‐old girl underwent a living‐related liver transplant, with reconstruction of hepatic artery of 2 mm in diameter under microscopy. She developed intestinal perforation requiring closure on day 4 post‐transplant and suffered from hepatic artery stenosis (HAS) on post‐transplant day 9. Conservative therapies, such as intravenous or transluminal administration of anti‐coagulants, vasodilators or fluids, were unsuccessful and caused remarkable general edema and multiple arrhythmias as a result of increased preload. On day 15 post‐transplant, because flow velocity was remarkably reduced (as shown by Doppler ultrasound) the patient underwent percutaneous transluminal angioplasty (PTA) using a kit for coronary angioplasty. The balloon catheter was inflated [first: 1.5 mm diameter, 4 atmospheric pressure (a.p.) for 30 seconds (s); second: 2.0 mm diameter, 4 a.p. for 30 s; third: 2.5 mm diameter, 10 a.p. for 30 s]. The stenosis was successfully dilated without any complication. The patient has been doing well with normal liver functions for 4 months after PTA. From this experience, PTA can be performed for HAS after liver transplantation, even in an infantile case, with a careful technique and a special device.