Endovascular management of venous complications post liver transplantation: a retrospective analysis of technical and clinical success

• A retrospective analysis of endovascular management for post-liver transplantation venous complications at a single quaternary referral center. • Demonstrates 100% technical success rate and 87.5% clinical success for percutaneous endovascular treatments including angioplasty and stenting. • Reports favorable outcomes with 81.3% target vessel patency and 93.8% organ preservation maintained at both 6 and 12 months. • Minimal procedure-related complications (2 patients) with all managed either endovascularly or conservatively, supporting safety profile. • Provides evidence for endovascular as a relatively safe and effective alternative approach to surgery in managing post-transplant venous complications. To evaluate the technical and clinical success of percutaneous endovascular management of venous complications post liver transplantation (LT). This single-center retrospective study analyzed 16 patients who underwent endovascular treatment for post-LT venous complications at a quaternary referral center between January 2019 and December 2023. The analysis evaluated technical success (<30% residual stenosis), clinical success (symptom resolution or improvement), target vessel patency and organ preservation (Olthoff criteria) at 6 and 12 months. The cohort included 16 patients (male:female ratio 9:7, median age 50 years), including 12 recipients from deceased donors and 4 from living donors. Technical success was achieved in 100% (16/16) of cases, with clinical success in 87.5% (14/16). Target vessel patency was maintained in 81.3% (13/16) at both 6 and 12 months. Organ preservation was achieved in 93.8% (15/16) at both 6 and 12 months. Procedure-related complications occurred in two patients: one managed endovascularly and one conservatively. One non-procedure-related complication was successfully managed endovascularly. Percutaneous endovascular treatment is a relatively safe and effective approach for post-LT venous complications, demonstrating high technical success rates and favorable clinical outcomes.