Hepatic artery stenosis

Case contributed by Dra. Mónica Mariana Azor

Presentation

Patient with a history of liver transplantation in the previous month with increased liver enzymes.

Patient Data

Age: 60
Gender: Male
Ultrasound

The color Doppler study shows a hepatic artery with antegrade flow, it presents a zone of turbulent flow whose maximum velocity is above the normal value. Distally, parvus tardus flow is observed. Preserved intrahepatic arterial flow with an IR of 0.5, below the value considered normal.
A collection is visualized adjacent to liver.

CT

Liver of normal size and shape.
Periportal and anterior vena cava collection with HU an average of 17.
The hepatic artery is patent, at the level of the anastomosis it shows a reduction in caliber.
Patent SMA and splenic artery.
Patent portal vein.
Permeable suprahepatic veins and vena cava.
Aorto-iliac atheromatosis.

DSA (angiography)

Digital angiography demonstrates the site of stenosis and the outcome of stenting therapy.

Case Discussion

Hepatic artery stenosis is less frequent complication than thrombosis within the arterial complications of liver transplants.
When it is suspected, in the early post-transplant stage, it should be differentiated of the anastomosis's inflammation expected.
The color and spectral Doppler evaluation in the stenotic area and distal vascular bed, together, are useful to the diagnosis.

After the endovascular procedure was realized and the collection, that resulted in a seroma was drained, the patient's liver enzymes began to decline.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.