Transcatheter Splenic Artery Occlusion for Treatment of
Splenic Artery Steal Syndrome After Orthotopic Liver
Transplantation |
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Authors: | Renan Uflacker J Bayne Selby Kenneth Chavin Jeffrey Rogers Prabhakar Baliga |
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Institution: | (1) Interventional Radiology, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, USA, USA;(2) Liver Transplant Service, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, USA, USA |
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Abstract: | Purpose: To review
some aspects of the problem of splenic artery steal syndrome as cause of
ischemia in transplanted livers and treatment by selective splenic artery
occlusion. Materials and Methods: Eleven liver
transplant patients from a group of 350 patients, nine men and two women,
ranging in age from 40 years to 61 years (mean 52 years), presented with
biochemical evidences of liver ischemia and failure, ranging from one to 60
days following orthotopic liver transplantation. Diagnosis of splenic artery
steal syndrome was suspected by elevated enzymes, Doppler ultrasound and
confirmed by celiac angiogram. Patients with confirmed hepatic artery
thrombosis before angiography were excluded from the study. Embolization with
Gianturco coils was performed. Results: All
patients were treated by splenic artery embolization with Gianturco coils. The
11 patients improved clinically within 24 hours of the procedure with
significant change in the biochemical and clinical parameters. Followup ranged
from one month to two years. One of the 11 patient initially improved, but
developed hepatic artery thrombosis within 24 hours of the embolic treatment,
requiring surgical repair. Conclusion: Splenic
artery steal syndrome following liver transplantation surgery can be diagnosed
by celiac angiography, and effectively treated by splenic artery embolization
with coils. Embolization is one of the treatments available, it is minimally
invasive, and leads to immediate clinical improvement. Hepatic artery
thrombosis is a possible complication of the procedure. |
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Keywords: | |
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