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Pseudoaneurysm of the common hepatic artery: treatment with a stent-graft
E Paci1, E Antico, R Candelari
1Department of Radiology, Regional Hospital Umberto 1-Torrette, Ancona, Italy. enripac@tiscalinet.it
Insights
A stent-graft successfully treated a common hepatic artery pseudoaneurysm in a patient with bile duct cancer. This minimally invasive approach excluded the aneurysm while preserving essential blood flow to the liver.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Hepatobiliary Surgery
Background:
- Pseudoaneurysms, particularly of the common hepatic artery, are rare but serious complications.
- Management of common hepatic artery pseudoaneurysms following complex hepatobiliary procedures presents significant challenges.
- Choledochal cholangiocarcinoma treatment can involve procedures that risk arterial injury.
Observation:
- A 67-year-old male developed severe bleeding from a drain post-operatively for choledochal cholangiocarcinoma.
- Hepatic arteriography revealed a pseudoaneurysm near the gastroduodenal artery origin.
- Initial attempts at arterial embolization were insufficient.
Findings:
- A stent-graft was deployed to bridge the pseudoaneurysm, effectively excluding it.
- The procedure successfully preserved normal hepatic arterial flow.
- This demonstrates the efficacy of stent-graft repair for common hepatic artery pseudoaneurysms.
Implications:
- Stent-graft placement offers a viable and potentially less invasive alternative to open surgical repair for common hepatic artery pseudoaneurysms.
- This technique may be particularly beneficial in patients with complex comorbidities or following extensive prior interventions.
- Further research into the long-term outcomes of stent-graft repair for visceral artery pseudoaneurysms is warranted.
Abstract:
We report a case of a pseudoaneurysm of the common hepatic artery treated with a stent-graft in a 67-year-old man. The patient presented with severe catheter bleeding through a drain following surgical and interventional procedures performed for therapeutic management of a choledochal cholangiocarcinoma. Selective hepatic arteriography showed a pseudoaneurysm close to the origin of the gastroduodenal artery. After a preliminary attempt at arterial embolization, it was decided to use a stent-graft to bridge the false aneurysm. Complete pseudoaneurysm exclusion was seen after the procedure with preservation of hepatic arterial flow.