Abstract
Purpose: To evaluate patency of refractory benign biliary strictures in liver transplant patients treated with retrievable stent-grafts. Materials and methods: Eight male liver transplant patients who ranged in age from 42 to 52 years developed nine symptomatic biliary strictures (intrahepatic left duct, 1; hilar, 2; anastomotic, 6). These strictures had recurred despite multiple previous attempts of treatment (n = 33), including angioplasty (n = 27), surgery (n = 1), atherectomy (n = 1), metallic stent (n = 1), and prolonged catheter drainage (n = 3). As an alternative method of treatment for these refractory biliary strictures, transhepatic placement of expanded polytetrafluoroethylene stent-grafts across the strictures was performed through 10-F sheaths. In total, 14 stent-grafts were placed to treat the nine lesions, and nine of these stent-grafts were subsequently retrieved through 12-16-F sheaths. Results: Stent-grafts were deployed successfully. Delayed migrations in two patients required additional stent-graft placement. One patient died of pneumonia 1 month after stent-graft placement; the remaining seven patients had stent-grafts successfully removed at 3-10 months (mean, 5.6 months). Nine intended stent-graft retrievals were performed successfully, with two requiring use of elongated forceps. Immediately after treatment, all strictures were widely patent. Five to 6 months after stent- graft removal in these seven patients, significant strictures recurred in four of eight lesions (50%). One patient underwent surgical revision. At 6-29 months (mean, 12 months) after stent-graft removal, the remaining six patients were without clinical or laboratory evidence of biliary obstruction, despite three patients with significant recurrent strictures. Conclusion: Temporary stent-graft placement for treatment of benign biliary strictures in liver transplant patients is technically feasible. Longer follow-up with larger patient series is necessary to assess effectiveness and possible broader applications.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 919-929 |
| Number of pages | 11 |
| Journal | Journal of Vascular and Interventional Radiology |
| Volume | 11 |
| Issue number | 7 |
| State | Published - 2000 |
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Keywords
- Bile ducts, stenosis or obstruction
- Bile ducts, stents and prostheses
- Liver, transplantation
- Stents and prostheses
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Radiological and Ultrasound Technology
Cite this
Treatment of refractory benign biliary stenoses in liver transplant patients by placement and retrieval of a temporary stent-graft : Work in progress. / Petersen, Bryan; Timmermans, Hans A.; Uchida, Barry; Rabkin, John M.; Keller, Frederick.
In: Journal of Vascular and Interventional Radiology, Vol. 11, No. 7, 2000, p. 919-929.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment of refractory benign biliary stenoses in liver transplant patients by placement and retrieval of a temporary stent-graft
T2 - Work in progress
AU - Petersen, Bryan
AU - Timmermans, Hans A.
AU - Uchida, Barry
AU - Rabkin, John M.
AU - Keller, Frederick
PY - 2000
Y1 - 2000
N2 - Purpose: To evaluate patency of refractory benign biliary strictures in liver transplant patients treated with retrievable stent-grafts. Materials and methods: Eight male liver transplant patients who ranged in age from 42 to 52 years developed nine symptomatic biliary strictures (intrahepatic left duct, 1; hilar, 2; anastomotic, 6). These strictures had recurred despite multiple previous attempts of treatment (n = 33), including angioplasty (n = 27), surgery (n = 1), atherectomy (n = 1), metallic stent (n = 1), and prolonged catheter drainage (n = 3). As an alternative method of treatment for these refractory biliary strictures, transhepatic placement of expanded polytetrafluoroethylene stent-grafts across the strictures was performed through 10-F sheaths. In total, 14 stent-grafts were placed to treat the nine lesions, and nine of these stent-grafts were subsequently retrieved through 12-16-F sheaths. Results: Stent-grafts were deployed successfully. Delayed migrations in two patients required additional stent-graft placement. One patient died of pneumonia 1 month after stent-graft placement; the remaining seven patients had stent-grafts successfully removed at 3-10 months (mean, 5.6 months). Nine intended stent-graft retrievals were performed successfully, with two requiring use of elongated forceps. Immediately after treatment, all strictures were widely patent. Five to 6 months after stent- graft removal in these seven patients, significant strictures recurred in four of eight lesions (50%). One patient underwent surgical revision. At 6-29 months (mean, 12 months) after stent-graft removal, the remaining six patients were without clinical or laboratory evidence of biliary obstruction, despite three patients with significant recurrent strictures. Conclusion: Temporary stent-graft placement for treatment of benign biliary strictures in liver transplant patients is technically feasible. Longer follow-up with larger patient series is necessary to assess effectiveness and possible broader applications.
AB - Purpose: To evaluate patency of refractory benign biliary strictures in liver transplant patients treated with retrievable stent-grafts. Materials and methods: Eight male liver transplant patients who ranged in age from 42 to 52 years developed nine symptomatic biliary strictures (intrahepatic left duct, 1; hilar, 2; anastomotic, 6). These strictures had recurred despite multiple previous attempts of treatment (n = 33), including angioplasty (n = 27), surgery (n = 1), atherectomy (n = 1), metallic stent (n = 1), and prolonged catheter drainage (n = 3). As an alternative method of treatment for these refractory biliary strictures, transhepatic placement of expanded polytetrafluoroethylene stent-grafts across the strictures was performed through 10-F sheaths. In total, 14 stent-grafts were placed to treat the nine lesions, and nine of these stent-grafts were subsequently retrieved through 12-16-F sheaths. Results: Stent-grafts were deployed successfully. Delayed migrations in two patients required additional stent-graft placement. One patient died of pneumonia 1 month after stent-graft placement; the remaining seven patients had stent-grafts successfully removed at 3-10 months (mean, 5.6 months). Nine intended stent-graft retrievals were performed successfully, with two requiring use of elongated forceps. Immediately after treatment, all strictures were widely patent. Five to 6 months after stent- graft removal in these seven patients, significant strictures recurred in four of eight lesions (50%). One patient underwent surgical revision. At 6-29 months (mean, 12 months) after stent-graft removal, the remaining six patients were without clinical or laboratory evidence of biliary obstruction, despite three patients with significant recurrent strictures. Conclusion: Temporary stent-graft placement for treatment of benign biliary strictures in liver transplant patients is technically feasible. Longer follow-up with larger patient series is necessary to assess effectiveness and possible broader applications.
KW - Bile ducts, stenosis or obstruction
KW - Bile ducts, stents and prostheses
KW - Liver, transplantation
KW - Stents and prostheses
UR - http://www.scopus.com/inward/record.url?scp=0033915285&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033915285&partnerID=8YFLogxK
M3 - Article
VL - 11
SP - 919
EP - 929
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
SN - 1051-0443
IS - 7
ER -