Non-surgical treatment of pseudoaneurysm of the hepatic artery and its branches
Iaccarino, V.; Marano, I.; Santini, G.; Della Noce, M.; Trivellini, V.
La Radiologia Medica 89(6): 841-845
1995
ISSN/ISBN: 0033-8362 PMID: 7644739 Document Number: 446510
The transcatheter embolization of hepatic artery pseudoaneurysms and of its branches is now considered the most effective tool for their treatment. These lesions are caused by abdominal traumas or inappropriate surgical treatment. These pseudoaneurysms must be treated promptly because they are at high risk for rupture, with subsequent complications such as hematemesis, hemobilia and hemoperitoneum. We treated 7 patients with pseudoaneurysms: 4 of them were in the right hepatic artery, 1 in a right hepatic artery branch, 1 in the common hepatic artery and 1 in the suprahilar hepatic artery. Two pseudoaneurysms were treated with Gianturco coils, 2 with Ivalon particles, 1 with Contour particles, 1 with fibrin particles and 1 with transcatheter occlusion with Bucrylat. Six of 7 patients recovered completely after embolization and in 1 patient only subsequent surgery was required. The success rate of transcatheter embolization was 85%. In our personal experience and from international literature reports, percutaneous embolization emerges as the safest therapeutic approach to hepatic artery pseudoaneurysms, yielding optimal results. In particular, percutaneous embolization is indicated for intrahepatic pseudoaneurysms and extraparenchymal saccular pseudoaneurysms of the common hepatic artery. Moreover, this technique exhibits a lower complication rate than surgery, whose mortality rate ranges 15-20%.