Purpose: To report the use of a rotational thrombectomy device for recanalization of a thrombosed hepatic artery bypass graft in an orthotopic liver transplant (OLT).

Case Report: Six months after a second OLT in a 52-year-old man, an iliac conduit used for an aortohepatic bypass became occluded, interrupting arterial supply to the liver transplant. The 8-F Straub Rotarex system was used to successfully remove clot from the bypass graft, avoiding embolization to the hepatic arteries. The recanalized conduit has remained patent for 1 year with the patient on an anticoagulation regimen.

Conclusions: The Rotarex thrombectomy system may be considered an alternative to other percutaneous interventions for the treatment of occluded bypass conduits supplying a liver transplant.

Keywords: liver transplantation, aortohepatic bypass graft, complication, thrombosis, mechanical thrombectomy