S2620 Percutaneous Transluminal Angioplasty vs Stenting for Hepatic Artery Stenosis After Liver Transplantation in Adults
Bibliographic record
Abstract
Introduction: Hepatic artery stenosis (HAS) is a serious complication of liver transplantation (LT), with no established guidelines for choosing between percutaneous transluminal Angioplasty (PTA) and stent. This study compared their outcomes to inform clinical practice. Methods: We searched PubMed, SCOPUS, Cochrane library, and Web of Science for studies comparing PTA and stenting in HAS patients after liver transplantation. The primary outcome was primary patency rate at 6 months, 12 months, and the end of follow-up. Secondary outcomes included technical success, major complications, Hepatic artery thrombosis (HAT) incidence, reintervention rates, and time to recurrent HAS. We also conducted a subgroup analysis based on major complication types, specifically artery dissection and rupture. Study quality was assessed using the Newcastle–Ottawa scale, and data analysis was performed using REVMAN 5.4.1. Results: Nine observational studies, including 325 patients with HAS after LT, were analyzed, with 140 treated with PTA alone and 197 with stents. No significant differences were found between stenting and PTA in primary patency rates at 6 months, 12 months, and the end of follow-up, as well as in technical success, major complications, artery dissection, artery rupture, and HAT incidence. However, stenting was significantly associated with a lower reintervention rate (RR = 0.57, 95% CI [0.36, 0.89], P = 0.01) and a longer time to recurrent HAS compared to PTA (MD = 36.42, 95% CI [14.14, 58.70], P = 0.001). Conclusion: Both PTA and stenting demonstrate comparable primary patency rates and safety outcomes, making them viable options for HAS treatment after liver transplantation. However, stenting was associated with a lower reintervention rate and a longer time to recurrent HAS, suggesting potential long-term benefits. Treatment selection should be individualized, considering anatomical factors, stenosis morphology, and operator expertise.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.004 |
| Bibliometrics | 0.004 | 0.009 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".