Stentgraft Implantation for the Treatment of Postoperative Hepatic Artery Pseudoaneurysm

Journal Article · Fri Apr 15 04:00:00 EDT 2016 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-015-1274-1· OSTI ID:22642548

Isfort, P.; Keil, S.; Goerg, F.; Zimmermann, M.; Liebl, M.; Schulze-Hagen, M. ^[1]; Schmeding, M. ^[2]; Kuhl, C. K.; Bruners, P. ^[1]

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1. RWTH Aachen University Hospital, Department of Diagnostic and Interventional Radiology (Germany)
2. RWTH Aachen University Hospital, Clinic for General, Visceral and Transplant Surgery (Germany)

PurposeHepatic artery pseudoaneurysms are a rare but potentially life-threatening complication of major pancreaticobiliary surgery. We evaluated the safety and efficacy of endovascular stentgraft implantation for the management of such vascular lesions.Materials and MethodsBetween May 2013 and October 2015, ten patients with postoperative hepatic artery pseudoaneurysm, of which eight presented with active hemorrhage, were treated with endovascular stentgraft implantation. All patients had undergone major pancreatic or hepatic surgery before (pylorus-preserving pancreaticoduodenectomy, pancreatectomy, hemihepatectomy, extended hemihepatectomy). The pseudoaneurysms were diagnosed 13–202 days after surgery and were associated with postsurgical complications (e.g., leakage of pancreaticojejunal anastomosis).ResultsIn 9/10 patients, the pseudoaneurysm was completely excluded via stentgraft implantation. In 1/10 patient, the pseudoaneurysm ruptured during the procedure and was successfully treated by immediate open surgery. In 1/10 patient, a second intervention was performed after 6 days because of rebleeding; this was successfully treated by implantation of a second overlapping stentgraft. Mean follow-up time is 51 days. None of the patients died due to stentgraft- or aneurysm-related complications. Further episodes of hemorrhage were not observed. In one patient, clinically asymptomatic complete occlusion of the stentgraft was discovered at follow-up imaging.ConclusionStentgraft implantation is a safe and effective technique to treat hepatic artery pseudoaneurysms related to major pancreatic or hepatic surgery, especially in the setting of acute hemorrhage.

• OSTI ID: 22642548
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 4 Vol. 39; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ADMINISTRATIVE PROCEDURES
ARTERIES
BIOMEDICAL RADIOGRAPHY
DIAGNOSIS
HEMORRHAGE
LIVER
PANCREAS
PATIENTS
RUPTURES
SURGERY