Percutaneous Management of a Hepatic Artery Aneurysm: Bleeding After Liver Transplantation
- University of Innsbruck, Department of Radiology I (Austria)
- University of Innsbruck, Transplant Surgery (Austria)
- University of Innsbruck, Department of Gastroenterology and Hepatology (Austria)
In this article we present an unusual case of hepatic artery aneurysm bleeding due to a hepatic artery thrombosis after liver transplantation. The patient developed a recurrent hepatic artery thrombosis leading to severe graft failure in four consecutive liver transplantations. While being evaluated for a fifth transplant, stabilization of the clinical situation was attempted by interventional therapy. The first intervention was to place a stent into the hepatic artery to prevent further ischemic damage. This failed to improve graft function, but unfortunately led to the development of a pseudoaneurysm at the distal end with a subsequent rupture into the biliary tree. Bleeding was treated successfully by direct puncture and coil embolization of the aneurysm. In addition, the patient demonstrated a hemodynamically relevant portal vein stenosis on the CT scan. Stenting of the portal vein markedly improved graft function. After extensive investigations, a paroxysmal nocturnal hemoglobinuria was found to be the underlying cause of the recurrent hepatic artery thrombosis. Here we suggest that hepatic artery aneurysm bleeding is a rare but potentially fatal complication that can be successfully treated by percutaneous coil embolization. Additionally, we propose that stenting of the portal vein can lead to a significant improvement of the graft perfusion even though the hepatic artery remained occluded.
- OSTI ID:
- 21088220
- Journal Information:
- Cardiovascular and Interventional Radiology, Vol. 27, Issue 5; Other Information: DOI: 10.1007/s00270-004-0170-x; Copyright (c) 2004 Springer-Verlag; Article Copyright (c) 2004 Springer-Verlag New York, LLC; Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
- Country of Publication:
- United States
- Language:
- English
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