Rescue Thrombectomy for Early Hepatic Artery Thrombosis Using Stent Retriever in a Child Post Combined Deceased Donor Liver and Renal Transplant

We report this case of a 5-year-old child post combined liver and renal transplant for primary hyperoxaluria. Patient developed hepatic artery thrombosis on day 3 posttransplant that was managed by reexploration and reanastomosis of the hepatic artery. On day 4, the patient again developed hepatic a...

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Main Authors: Manish Kumar Yadav, Madhavan Unni, Shabeer Ali U.T., Shiraz Ahmed Rather, B. Venugopal
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2021-04-01
Series:Journal of Clinical Interventional Radiology ISVIR
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1728984
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author Manish Kumar Yadav
Madhavan Unni
Shabeer Ali U.T.
Shiraz Ahmed Rather
B. Venugopal
author_facet Manish Kumar Yadav
Madhavan Unni
Shabeer Ali U.T.
Shiraz Ahmed Rather
B. Venugopal
author_sort Manish Kumar Yadav
collection DOAJ
description We report this case of a 5-year-old child post combined liver and renal transplant for primary hyperoxaluria. Patient developed hepatic artery thrombosis on day 3 posttransplant that was managed by reexploration and reanastomosis of the hepatic artery. On day 4, the patient again developed hepatic artery thrombosis that failed to revascularize by surgical exploration and reanastomosis. Tissue plasminogen activator was injected into the hepatic artery intraoperatively to lyse any clot; however, no revascularization could be achieved. Subsequently, catheter angiogram confirmed no flow in the hepatic artery. A4 × 22 mm revive stent retriever was deployed across the site of occlusion and retrieved after 5 minutes of indwell time. Two such passes were made and complete recanalization of the hepatic artery was achieved. The hepatic artery remained patent as confirmed on serial Doppler images post intervention.
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issn 2456-4869
language English
publishDate 2021-04-01
publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format Article
series Journal of Clinical Interventional Radiology ISVIR
spelling doaj-art-d624dced3a6040f482a08d1c5091b1942025-08-20T02:19:38ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Clinical Interventional Radiology ISVIR2456-48692021-04-01050319319510.1055/s-0041-1728984Rescue Thrombectomy for Early Hepatic Artery Thrombosis Using Stent Retriever in a Child Post Combined Deceased Donor Liver and Renal TransplantManish Kumar Yadav0Madhavan Unni1Shabeer Ali U.T.2Shiraz Ahmed Rather3B. Venugopal4Division of Interventional Radiology, Department of Radiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, IndiaDepartment of Radiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, IndiaDepartment of Hepatobiliary, Pancreatic and Liver Transplant Surgery, Kerala Institute of Medical Sciences, Trivandrum, Kerala, IndiaDepartment of Hepatobiliary, Pancreatic and Liver Transplant Surgery, Kerala Institute of Medical Sciences, Trivandrum, Kerala, IndiaDepartment of Hepatobiliary, Pancreatic and Liver Transplant Surgery, Kerala Institute of Medical Sciences, Trivandrum, Kerala, IndiaWe report this case of a 5-year-old child post combined liver and renal transplant for primary hyperoxaluria. Patient developed hepatic artery thrombosis on day 3 posttransplant that was managed by reexploration and reanastomosis of the hepatic artery. On day 4, the patient again developed hepatic artery thrombosis that failed to revascularize by surgical exploration and reanastomosis. Tissue plasminogen activator was injected into the hepatic artery intraoperatively to lyse any clot; however, no revascularization could be achieved. Subsequently, catheter angiogram confirmed no flow in the hepatic artery. A4 × 22 mm revive stent retriever was deployed across the site of occlusion and retrieved after 5 minutes of indwell time. Two such passes were made and complete recanalization of the hepatic artery was achieved. The hepatic artery remained patent as confirmed on serial Doppler images post intervention.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1728984combined deceased donor liver and renal transplanthepatic artery thrombosisstent retrievermechanical thrombectomy
spellingShingle Manish Kumar Yadav
Madhavan Unni
Shabeer Ali U.T.
Shiraz Ahmed Rather
B. Venugopal
Rescue Thrombectomy for Early Hepatic Artery Thrombosis Using Stent Retriever in a Child Post Combined Deceased Donor Liver and Renal Transplant
Journal of Clinical Interventional Radiology ISVIR
combined deceased donor liver and renal transplant
hepatic artery thrombosis
stent retriever
mechanical thrombectomy
title Rescue Thrombectomy for Early Hepatic Artery Thrombosis Using Stent Retriever in a Child Post Combined Deceased Donor Liver and Renal Transplant
title_full Rescue Thrombectomy for Early Hepatic Artery Thrombosis Using Stent Retriever in a Child Post Combined Deceased Donor Liver and Renal Transplant
title_fullStr Rescue Thrombectomy for Early Hepatic Artery Thrombosis Using Stent Retriever in a Child Post Combined Deceased Donor Liver and Renal Transplant
title_full_unstemmed Rescue Thrombectomy for Early Hepatic Artery Thrombosis Using Stent Retriever in a Child Post Combined Deceased Donor Liver and Renal Transplant
title_short Rescue Thrombectomy for Early Hepatic Artery Thrombosis Using Stent Retriever in a Child Post Combined Deceased Donor Liver and Renal Transplant
title_sort rescue thrombectomy for early hepatic artery thrombosis using stent retriever in a child post combined deceased donor liver and renal transplant
topic combined deceased donor liver and renal transplant
hepatic artery thrombosis
stent retriever
mechanical thrombectomy
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1728984
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AT shabeeraliut rescuethrombectomyforearlyhepaticarterythrombosisusingstentretrieverinachildpostcombineddeceaseddonorliverandrenaltransplant
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