Angioplasty using covered stents in five patients with symptomatic pulmonary artery stenosis after single-lung transplantation

Ahuva Grubstein, Eli Atar, Sergey Litvin, Alexander Belenky, Michael Knizhnik, Benjamin Medalion, Yael Raviv, Mordechai R. Kramer, Benjamin D. Fox

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objective: After lung transplantation, pulmonary artery stenosis (PAS) may occur at the anastomotic site, resulting in poor graft function and hypoxemia. Surgical repair has been the standard-of-care, although percutaneous angioplasty with stent insertion has been performed in patients unsuitable for surgery. We summarize our experience of pulmonary artery stent-graft placement in transplant recipients who were also fit for surgical repair. Materials and Methods: Retrospective review of five cases of single-lung transplant recipients (4 male, 1 female, median age 61 years) who underwent percutaneous angioplasty and insertion of stent-graft for severe PAS. Balloon-expandable stent-grafts were used that were tailored to the donor and recipient vessel diameters. Results: Stenosis was diagnosed with computed tomography angiography at a median of 44 days (range 22-84) after transplantation. All stent placements were technically successful. There was only one periprocedural complication, a haemothorax that was drained. In four patients, the angioplasty improved the lung function; relative graft perfusion (as assessed by quantitative lung scintigraphy) improved by 26 % (IQR 13-37); and SpO2 improved by 8 % (IQR 4-9). Conclusion: Percutaneous angioplasty using stent-graft is a minimally invasive, safe, and efficacious procedure for treatment of posttransplantation PAS and should be considered as an alternative to surgery even when the patient is considered fit for surgical repair.

Original languageEnglish
Pages (from-to)686-690
Number of pages5
JournalCardioVascular and Interventional Radiology
Volume37
Issue number3
DOIs
StatePublished - 1 Jan 2014
Externally publishedYes

Keywords

  • Angioplasty/angiogram
  • Arterial intervention
  • Clinical practice
  • Endovascular treatment
  • Lung/pulmonary
  • Stenosis/restenosis

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