Related Experiment Videos
[Hepatic artery aneurysms]
O Glehen1, P Feugier, C Ducerf
1Service de chirurgie générale et thoracique, centre hospitalier Lyon-Sud, 69495 Pierre Bénite, France. olivier.glehen@chu-lyon.fr
Insights
This study reviewed nine hepatic artery aneurysms, finding surgical management generally effective. Restoration of hepatic arterial blood supply is crucial for proper hepatic artery aneurysms.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Hepatobiliary Surgery
Context:
- Hepatic artery aneurysms are rare vascular lesions.
- They can present asymptomatically, with rupture, or cholestasis.
- Associated conditions include hepatocellular carcinoma and pancreatic cancer.
Purpose:
- To report a series of nine hepatic artery aneurysms (real, pseudo, and false).
- To analyze clinical characteristics, management, and outcomes.
- To determine therapeutic indications for hepatic artery aneurysms.
Summary:
- Nine patients with hepatic artery aneurysms were treated between 1987 and 1999.
- Eight patients underwent surgery, with successful revascularization in six using various grafts or sutures.
- Embolization had limited success, and surgical management was preferred, especially for proper hepatic artery aneurysms.
Impact:
- Highlights the variability in presentation and management of hepatic artery aneurysms.
- Emphasizes the necessity of surgical intervention for proper hepatic artery aneurysms.
- Provides insights into outcomes of surgical and endovascular treatments for these rare conditions.
Aim Of The Study:
The aim of this retrospective study was to report a series of nine aneurysms of the hepatic arteries, including real aneurysms (n = 4), pseudoaneurysms (n = 3) and false aneurysms (n = 2) observed from 1987 to 1999.
Patients:
There were 7 men and 2 women (mean age: 58 years). In 3 cases, the aneurysm was asymptomatic and detected by sonography; in 4 cases it was revealed by rupture with a severe hemorrhage and in 2 cases by cholestasis. The aneurysm was located on right (n = 3), proper and common (n = 3), proper (n = 2), and common (n = 1) hepatic arteries. The aneurysm was associated with hepatocellular carcinoma (n = 1), carcinoma of the head of the pancreas (n = 1) and liver metastases (n = 1).
Methods And Results:
Eight patients were operated and one of them was operated three times. Hepatic arterial blood supply was restored in 6 patients with simple suture (n = 1), Goretex graft (n = 2), allograft (n = 2) and autologous vein (n = 1), with one failure which required liver retransplantation. Only one of the three attempts of embolization was successful. One patient with surgical contraindications died from hemobilia after embolization failure. During follow-up, there was one thrombosis of the common hepatic artery which had been excluded and two late deaths: one from rupture of a false aneurysm after bypass with an allograft and one by terminal progression of the cancer. The other 6 patients were alive at the time of this study.
Conclusion:
Clinical characteristics and therapeutic indications of hepatic arterial aneurysm are variable. Management is usually surgical, while embolization is reserved for special circumstances. Restoration of the hepatic arterial blood supply is necessary in aneurysms located on the proper hepatic artery.