Splenic Artery Transposition Graft for Hepatic Artery Aneurysm and Occlusion

Hepatic artery aneurysms are rare but potentially fatal if undiagnosed or left untreated. Several open surgical and endovascular techniques for hepatic artery aneurysm (HAA) repair have been described. Splenic artery transposition has been reported in selected cases.

We herein present the case of a 73-year-old man with asymptomatic HAA and concomitant occlusion at the most proximal tract. The aneurysm involved the common and proper hepatic artery and was supplied by the gastroduodenal artery. Aneurysmectomy was performed, and the arterial blood flow was restored to the liver by splenic artery transposition graft. No signs of liver or spleen ischemia were detected at control computed tomography angiography. The patient is doing fine 3 months after surgery.

This case presented multiple challenges because of HAA location and extension and lack of a traditional inflow site for hepatic revascularization. In such setting, splenic artery transposition was shown to represent a feasible and successful technique.