Barahman M, Alanis L, DiNorcia J, Moriarty JM, McWilliams JP. Hepatic artery stenosis angioplasty and implantation of Wingspan neurovascular stent: A case report and discussion of stenting in tortuous vessels. World J Gastroenterol 2020; 26(4): 448-455 [PMID: 32063693 DOI: 10.3748/wjg.v26.i4.448]
Corresponding Author of This Article
Justin P McWilliams, MD, Associate Professor, Director, Division of Interventional Radiology, Ronald Reagan Medical Center at UCLA, David Geffen School of Medicine at UCLA, 757 Westwood Ave., Los Angeles, CA 90095, United States. jumcwilliams@mednet.ucla.edu
Research Domain of This Article
Transplantation
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jan 28, 2020; 26(4): 448-455 Published online Jan 28, 2020. doi: 10.3748/wjg.v26.i4.448
Hepatic artery stenosis angioplasty and implantation of Wingspan neurovascular stent: A case report and discussion of stenting in tortuous vessels
Mark Barahman, Lourdes Alanis, Joseph DiNorcia, John M Moriarty, Justin P McWilliams
Mark Barahman, Department of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, United States
Lourdes Alanis, John M Moriarty, Justin P McWilliams, Department of Radiology, Division of Interventional Radiology, Ronald Reagan Medical Center at UCLA, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
Lourdes Alanis, John M Moriarty, Justin P McWilliams, Division of Interventional Radiology, Ronald Reagan Medical Center at UCLA, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
Joseph DiNorcia, Department of Surgery, Ronald Reagan Medical Center at UCLA, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
Author contributions: Barahman M participated in the case and prepared the manuscript; Alanis L participated in the case and prepared the manuscript; DiNorcia J performed the liver transplant and prepared the manuscript; Moriarty JM performed the first endovascular procedure and prepared the manuscript; McWilliams JP performed the second endovascular procedure and prepared the manuscript.
Informed consent statement: The patient provided informed consent for all aspects of care described in this manuscript.
Conflict-of-interest statement: The authors have no conflicts to declare
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Justin P McWilliams, MD, Associate Professor, Director, Division of Interventional Radiology, Ronald Reagan Medical Center at UCLA, David Geffen School of Medicine at UCLA, 757 Westwood Ave., Los Angeles, CA 90095, United States. jumcwilliams@mednet.ucla.edu
Received: October 16, 2019 Peer-review started: October 16, 2019 First decision: November 22, 2019 Revised: December 5, 2019 Accepted: January 2, 2020 Article in press: January 2, 2020 Published online: January 28, 2020 Processing time: 93 Days and 10.7 Hours
Abstract
BACKGROUND
Hepatic artery stenosis is a complication of orthotopic liver transplant occurring in 3.1%-7.4% of patients that can result in graft failure and need for re-transplantation. Endovascular therapy with angioplasty and stenting has been used with a high degree of technical success and good clinical outcomes, but tortuous hepatic arteries present a unique challenge for intervention. Suitable stents for this application should be maneuverable and conformable while also exerting adequate radial force to maintain a patent lumen.
CASE SUMMARY
Herein we report our experience with a neurovascular Wingspan stent system in a challenging case of recurrent hepatic artery stenosis and discuss the literature of stenting in tortuous transplant hepatic arteries.
CONCLUSION
Wingspan neurovascular stent is self-expanding, has good conformability, and adequate radial resistance and as such it could be added to the armamentarium of interventionalists in the setting of a tortuous and stenotic transplant hepatic artery.
Core tip: Endovascular therapy of hepatic artery stenosis using angioplasty and stenting can be performed by interventional radiologists and has good outcomes and safety record, reducing the need for surgical revascularization or re-transplantation. The Wingspan neurovascular stent is a new self-expanding stent that has good conformability, maneuverability and adequate radial resistance for this application.
