Splenic Artery Syndrome After Orthotopic Liver Transplantation: Treatment With the Amplatzer Vascular Plug

Journal Article · Thu Dec 15 00:00:00 EST 2011 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-010-0083-9· OSTI ID:21608641

Maurer, M H ^[1]; Mogl, M T ^[2]; Podrabsky, P; Denecke, T; Grieser, C; Froeling, V; Scheurig-Muenkler, C ^[1]; Guckelberger, O ^[2]

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1. Charite-Universitaetsmedizin Berlin, Klinik fuer Strahlenheilkunde (Germany)
2. Charite-Universitaetsmedizin Berlin, Klinik fuer Allgemein-, Visceral-, und Transplantationschirurgie (Germany)

Purpose: To evaluate the safety and efficacy of the Amplatzer vascular plug (AVP) for embolization of the splenic artery in patients with hepatic hypoperfusion after orthotopic liver transplantation (OLT). Materials and Methods: Thirteen patients (9 men and 4 women) with a mean age of 56 years (range 22-70) who developed splenic artery syndrome after OLT with decreased liver perfusion and clinically relevant impairment of liver function (increased transaminase or serum bilirubin levels, thrombocytopenia, and/or therapy-refractory ascites) were treated by embolization of the proximal third of the splenic artery using the AVP. The plugs ranged in diameter from 6 to 16 mm, and they were introduced through femoral (n = 9), axillary (n = 3), or brachial (n = 1) access using a 5F or 8F guiding catheter. Results: The plugs were successfully placed, and complete occlusion of the splenic artery was achieved in all patients. Placement of two plugs was necessary for complete occlusion in 3 of the 13 patients. Occlusion took on average 10 min (range 4-35). There was no nontarget embolization or plug migration into more distal segments of the splenic artery. All patients showed improved arterial perfusion, including the liver periphery, on postinterventional angiogram. After embolization, liver function parameters (transaminase and bilirubin levels) improved with normalization of concomitant thrombocytopenia and a decrease in ascites volume. Conclusion: Our initial experience in a small patient population with SAS suggests that the AVP enables precise embolization of the proximal splenic artery, thus providing safe and effective treatment for poor liver perfusion after OLT due to SAS.

• OSTI ID: 21608641
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 34, Issue 6; Other Information: DOI: 10.1007/s00270-010-0083-9; Copyright (c) 2011 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
AMINOTRANSFERASES
ARTERIES
ASCITES
BILIRUBIN
LIVER
MATERIALS
MEN
PATIENTS
SAFETY
THERAPY
WOMEN
ANIMALS
AZOLES
BLOOD VESSELS
BODY
CARBOXYLIC ACIDS
CARDIOVASCULAR SYSTEM
DIGESTIVE SYSTEM
ENZYMES
FEMALES
GLANDS
HETEROCYCLIC ACIDS
HETEROCYCLIC COMPOUNDS
MALES
MAMMALS
MAN
MEDICINE
NITROGEN TRANSFERASES
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PATHOLOGICAL CHANGES
PIGMENTS
PRIMATES
PROTEINS
PYRROLES
SYMPTOMS
TRANSFERASES
VERTEBRATES