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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2021; 05(03): 193-195
DOI: 10.1055/s-0041-1728984
Letter to the Editor

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

Manish Kumar Yadav
1   Division of Interventional Radiology, Department of Radiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Madhavan Unni
2   Department of Radiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Shabeer Ali U.T.
3   Department of Hepatobiliary, Pancreatic and Liver Transplant Surgery, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Shiraz Ahmed Rather
3   Department of Hepatobiliary, Pancreatic and Liver Transplant Surgery, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
B. Venugopal
3   Department of Hepatobiliary, Pancreatic and Liver Transplant Surgery, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
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Abstract

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.

Keywords

combined deceased donor liver and renal transplant - hepatic artery thrombosis - stent retriever - mechanical thrombectomy


Publication History

Article published online:
29 April 2021

© 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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