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PCI Safe and Feasible in End-Stage Liver Disease

Percutaneous coronary intervention for coronary artery disease safe for liver transplant candidates

MONDAY, July 4 (HealthDay News) -- Percutaneous coronary intervention (PCI) for coronary artery disease (CAD) is safe and feasible for liver transplant candidates with end-stage liver disease (ESLD), according to a study published in the July issue of Liver Transplantation.

Babak Azarbal, M.D., from the Cedars-Sinai Medical Center in Los Angeles, and colleagues investigated the feasibility and safety of PCI in liver transplant candidates. A total of 16 participants with ESLD hemodynamically significant CAD who were otherwise satisfactory candidates for liver transplantation underwent PCI; 15 with bare-metal stents, and one with only balloon angioplasty. The procedural success rates, rates of mortality and myocardial infarction, and bleeding outcomes were assessed.

The investigators found that the median diameter stenosis in each lesion was 80 percent, and the the median platelet count was 68 x 109/L. A total of 94 percent of the patients had successful PCI. Post-stenting, one patient had suboptimal residual stenosis of 50 percent. There were no deaths, in-hospital or at 30 days, no myocardial infarctions, and no hematoma formations. Two patients required transfusions: one a unit of platelets and the other a unit of packed red blood cells. At one month post-PCI, all patients remained clinically stable. Nine of the 16 patients listed for liver transplantation, and three of them underwent the transplant procedure.

"We have demonstrated the safety and feasibility of performing PCI in a small cohort of patients with ESLD and hemodynamically significant CAD, the majority of whom had significant thrombocytopenia," the authors write.

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