Endovascular Management of Early Lung Transplant–Related Anastomotic Pulmonary Artery Stenosis

Successful angioplasties using high pressure large balloons in a patient with severe anastomotic pulmonary artery stenosis soon after single-lung transplantation

“…The safety and effectiveness of balloon angioplasty and stent implantation for anastomotic PAS after lung transplantation have been reported [1,3,4,6,7]. However, there is no published study comparing these two interventions for their safety and effectiveness.…”

“…It is important to reduce the infection risk in transplant recipients because they are immunocompromised hosts, who are on life-long immunosuppressive agents. Anaya-Ayala et al reported a high incidence of sepsis-related mortality in 2 of 19 cases (11%) within 2 weeks after diagnostic cardiac catheterization in lung-transplant recipients [7]. Since foreign bodies will further increase the infection risk in transplant recipients, balloon angioplasty should be the first choice for anastomotic PAS, and stent implantation should be the second option if the balloon angioplasty is ineffective.…”

Medical Course and Complications After Lung Transplantation

“…Vascular anastomotic complications can arise either early or late in the post-transplant course and can have very severe adverse consequences. Pulmonary artery stenosis can be secondary to mechanical kinking, disruption, or narrowing of the anastomosis, sometimes due to the particulars of donor anatomy or due to thrombosis [25]. The clinical picture is usually consistent with pulmonary hypertension and right ventricular failure.…”

Imaging features of intrathoracic complications of lung transplantation: What the radiologists need to know

“…Pulmonary artery stenosis can occur early or late after lung transplantation and is generally a result of incongruent lengths of the donor and recipient segments, technical narrowing or twisting of the anastomosis[ 14 ].…”