Stentgraft Implantation for the Treatment of Postoperative Hepatic Artery Pseudoaneurysm
| Autor: | Philipp Bruners, Peter Isfort, Maximilian Schulze-Hagen, Fabian Goerg, Martin Liebl, Federico Pedersoli, Markus Zimmermann, Sebastian Keil, Maximilian Schmeding, Christiane K. Kuhl |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Prosthesis Implantation 030204 cardiovascular system & hematology Asymptomatic 030218 nuclear medicine & medical imaging Blood Vessel Prosthesis Implantation 03 medical and health sciences Pseudoaneurysm Hepatic Artery 0302 clinical medicine Blood vessel prosthesis medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Aged Postoperative Care business.industry Endovascular Procedures Middle Aged Pancreaticoduodenectomy medicine.disease Blood Vessel Prosthesis Surgery medicine.anatomical_structure Pancreatectomy cardiovascular system Stents Radiology medicine.symptom Cardiology and Cardiovascular Medicine Complication business Aneurysm False Artery |
| Zdroj: | CardioVascular and Interventional Radiology. 39:575-581 |
| ISSN: | 1432-086X 0174-1551 |
| DOI: | 10.1007/s00270-015-1274-1 |
| Popis: | Hepatic 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. Between 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). In 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. Stentgraft 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. |
| Databáze: | OpenAIRE |
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