• CLTI
• below the knee
• chronic limb-threatening ischemia
• endovascular revascularization

• Humans
• Treatment Outcome
• Risk Factors
• Limb Salvage
• Lower Extremity/blood supply
• Peripheral Arterial Disease/diagnostic imaging
• Peripheral Arterial Disease/therapy
• Endovascular Procedures/adverse effects
• Endovascular Procedures/methods
• Ischemia/diagnostic imaging
• Ischemia/therapy
• Retrospective Studies
• Chronic Disease

• atherectomy
• diagnosis
• endovascular
• intervention
• optical coherence tomography
• peripheral arterial disease
• vascular

Percutaneous transluminal angioplasty and stenting represent an effective treatment for hepatic artery stenosis after liver transplantation. In the first year after stenting, approximately 22% of patients experience in-stent restenosis, increasing the risk of artery thrombosis and related complications, and 50% experience liver failure. Although angiography is an important tool for diagnosis and the planning of therapeutic interventions, it may raise doubts, especially in small-diameter arteries, and it provides low resolution rates compared with newer intravascular imaging methods, such as optical coherence tomography (OCT).

A 64-year-old male developed hepatic artery stenosis one year after orthotropic liver transplantation and was successfully treated with percutaneous transluminal angioplasty with stenting. Five months later, the Doppler ultrasound results indicated restenosis. Visceral arteriography confirmed hepatic artery tortuosity but was doubtful for significant in-stent restenosis (ISR) and intrahepatic flow reduction. To confirm ISR, identify the etiology and guide treatment, OCT was performed. OCT showed severe stenosis due to four mechanisms: Focal and partial stent fracture, late stent malapposition, in-stent neointimal hyperplasia, and neoatherosclerosis.

Intravascular diagnostic methods can be useful in evaluating cases in which initial angiography results are not sufficient to provide a proper diagnosis of significant stenosis, especially with regard to ISR. A wide range of diagnoses are provided by OCT, resulting in different treatment options. Interventional radiologists should consider intravascular diagnostic methods as additional tools for evaluating patients when visceral angiography results are unclear.

• Liver transplantation
• Hepatic artery restenosis
• Tomography
• Optical coherence
• Case report
• Endovascular procedures
• Angiography

• Optical coherence tomography (OCT)
• bioresorbable vascular scaffold (BRS)

• Carotid artery stenting
• Double Layer mesh stent
• Optical coherence tomography (OCT)