Endoluminal management of arterioportal fistulae in liver transplant recipients: A single-center experience

Wael E.A. Saad, Mark G. Davies, Deborah J. Rubens, Lawrence G. Sahler, Nikhil C. Patel, David E. Lee, Takashi Kitanosono, Talia Sasson, David L. Waldman

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Transcatheter embolization of arterioportal fistulae in liver transplant recipients is restricted to symptomatic arterioportal fistulae. Angiograms of liver transplant recipients from a single university medical center were retrospectively reviewed. Hemodynamically significant arterioportal fistulae were defined as those exhibiting opacification of the main portal vein of the transplanted hepatic graft or its first order branch with or without portal venous changes by Doppler ultrasound imaging. Six arterioportal fistulae were found. Doppler ultrasound imaging detected 50% of all arterioportal fistulae and all 3 hemodynamically significant arterioportal fistulae. Three successful embolizations were performed. Follow-up (37 to 67 months) demonstrated patent hepatic arteries and no parenchymal ischemic changes with graft preservation. High-throughput arterioportal fistulae may require larger intrahepatic artery branch embolization. There is a window of opportunity for embolizing significant arterioportal fistulae before their progression to large symptomatic, high through-put arterioportal fistulae with their added risk of ischemic changes before and after embolization.

Original languageEnglish (US)
Pages (from-to)451-459
Number of pages9
JournalVascular and Endovascular Surgery
Volume40
Issue number6
DOIs
StatePublished - Dec 2006
Externally publishedYes

Keywords

  • Arterioportal fistulae
  • Doppler ultrasound
  • Embolization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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