Gastroduodenal artery steal syndrome treated with coil embolization after orthotopic liver transplantation
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Gastroduodenal artery steal syndrome is an uncommon complication occurring after orthotopic liver transplantation (OLT) that results in hypoperfusion of the hepatic artery increasing the risk for graft dysfunction. Its non-specific clinical and imaging findings often delay diagnosis and increase the chance for re-transplantation or death. The lack of diagnostic criteria and definitive risk factors for developing the syndrome creates a need for angiography to visualize anatomical and perfusion characteristics indicative of the phenomenon. We present a 47-year-old male who underwent OLT and developed gastroduodenal artery steal a week after surgery. The diagnosis was confirmed with angiogram and successfully treated with coil embolization of the gastroduodenal artery. Arterial steal syndromes should be part of the broad differential when encountered with findings suggestive of an arterial complications in post-OLT patients.
Abstract
Gastroduodenal artery steal syndrome is an uncommon complication occurring after orthotopic liver transplantation (OLT) that results in hypoperfusion of the hepatic artery increasing the risk for graft dysfunction. Its non-specific clinical and imaging findings often delay diagnosis and increase the chance for re-transplantation or death. The lack of diagnostic criteria and definitive risk factors for developing the syndrome creates a need for angiography to visualize anatomical and perfusion characteristics indicative of the phenomenon. We present a 47-year-old male who underwent OLT and developed gastroduodenal artery steal a week after surgery. The diagnosis was confirmed with angiogram and successfully treated with coil embolization of the gastroduodenal artery. Arterial steal syndromes should be part of the broad differential when encountered with findings suggestive of an arterial complications in post-OLT patients.
참고문헌 (13)
- Pérez-Saborido B, "Incidence, management, and results of vascular complications after liver transplantation", Transplant Proc, 43, pp.749~750 (2011)
- Frongillo F, "Diagnosis and management of hepatic artery complications after liver transplantation", Transplant Proc, 47, pp.2150~2155 (2015)
- Saad WE, "Nonocclusive hepatic artery hypoperfusion syndrome (splenic steal syndrome) in liver transplant recipients", Semin Intervent Radiol, 29, pp.140~146 (2012)
- Saad WE, "Management of nonocclusive hepatic artery complications after liver transplantation", Tech Vasc Interv Radiol, 10, pp.221~232 (2007)
- Sanyal R, "Role of imaging in the management of splenic artery steal syndrome", J Ultrasound Med, 28, pp.471~477 (2009)
- Pinto S, "Splenic Artery Syndrome after orthotopic liver transplantation: a review", Int J Surg, 12, pp.1228~1234 (2014)
- Uflacker R, "Transcatheter splenic artery occlusion for treatment of splenic artery steal syndrome after orthotopic liver transplantation", Cardiovasc Intervent Radiol, 25, pp.300~306 (2002)
- Li C, "Current understanding and management of splenic steal syndrome after liver transplant: a systematic review", Transplant Rev (Orlando), 31, pp.188~192 (2017)
- Nüssler NC, "Diagnosis and treatment of arterial steal syndromes in liver transplant recipients", Liver Transpl, 9, pp.596~602 (2003)
- Mogl MT, "Evolving experience with prevention and treatment of splenic artery syndrome after orthotopic liver transplantation", Transpl Int, 23, pp.831~841 (2010)
- Umeda Y, "Preoperative proximal splenic artery embolization: a safe and efficacious portal decompression technique that improves the outcome of live donor liver transplantation", Transpl Int, 20, pp.947~955 (2007)
- Nishida S, "Gastroduodenal artery steal syndrome during liver transplantation: intraoperative diagnosis with Doppler ultrasound and management", Transpl Int, 18, pp.350~353 (2005)
- Quintini C, "“Splenic artery steal syndrome” is a misnomer: the cause is portal hyperperfusion, not arterial siphon", Liver Transpl, 14, pp.374~379 (2008)