Covered stent placement for hepatic artery pseudoaneurysm

Cui, Li; Lu, Kai; Bai, Yanhua; Li, Xiaohui; Wang, Xiu-Qi; Hao, Jiheng; Duan, Feng

doi:10.1007/s00261-020-02452-3

Cited by 30 publications

(13 citation statements)

References 12 publications

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“…Put the patient in the supine position, first locate the tumor, mark the puncture point under CT or B ultrasound, then use lidocaine at a concentration of 0.5% to give the patient local anesthesia, and finally give the patient a radiofrequency ablation treatment [5]. e parameters of the radiofrequency ablation machine are set as follows: the power range is 30-50 W and the temperature range is 90-105 °C.…”

Section: Radiofrequency Ablation Treatment Methodsmentioning

confidence: 99%

Effect of Radiofrequency Ablation with Interventional Therapy of Hepatic Artery on the Recurrence of Primary Liver Cancer and the Analysis of Influencing Factors

Zhang

Zhao

Dong

2021

Journal of Oncology

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Background. The probability of liver cancer recurring in patients after surgery is a serious threat to liver cancer patients. Radiofrequency ablation is widely employed in liver cancer cases. We explored the therapeutic effects and influencing factors of radiofrequency ablation combined with hepatic artery intervention in patients with recurrence of primary liver cancer surgery. Methods. 90 patients with primary liver cancer postoperative recurrence admitted to our hospital from January 2014 to February 2017 were selected as the research objects. The patients were randomly divided into the control group (n = 45) and combined treatment group (n = 45). The combined treatment group received radiofrequency ablation combined with hepatic artery interventional therapy, and the control group received hepatic artery interventional therapy. The short-term efficacy, AFP levels before and after treatment, and long-term survival results of the two groups were compared. Single-factor and multifactor analyses of the clinical information of the combined treatment group were carried out to find out the factors affecting the therapeutic effect of radiofrequency ablation combined with hepatic artery intervention on patients with recurrence of primary liver cancer. Results. The total effective rate of short-term curative effect of the combined treatment group was higher than the control group, and there was a statistically significant difference existing ( P < 0.05). After treatment, two groups of patients’ AFP levels were greatly lower than before treatment, the AFP levels of the combined treatment group were significantly lower than the control group, and there was a statistically significant difference ( P < 0.05). The survival rates of patients in the combined treatment group at the sixth month, the first year, and the second year after treatment were significantly higher than those of the control group, and there was a statistically significant difference ( P < 0.05). The univariate results showed that, in the combined treatment group, there were statistically significant differences between the effective group and the ineffective group in tumor diameter, intact capsule, liver cirrhosis, intrahepatic spread, and tumor adjacent to large blood vessels ( P < 0.05). The outcomes of multivariate analysis indicated that tumor diameter ≥ 3 cm, incomplete capsule, intrahepatic spread, and tumor adjacent to large blood vessels were risk factors for ineffective recurrence of patients with primary liver cancer after radiofrequency ablation combined with hepatic artery intervention ( P < 0.05). Discussion. Tumor diameter ≥ 3 cm, incomplete capsule, intrahepatic spread, and tumor adjacent to large blood vessels are risk factors for the ineffectiveness of radiofrequency ablation combined with hepatic artery interventional therapy for patients with recurrence of primary liver cancer. It is necessary to increase the range of radiofrequency treatment, increase the temperature of the radiofrequency needle, and strengthen postoperative follow-up interventions based on the specific conditions of the patient's tumor.

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Section: Radiofrequency Ablation Treatment Methodsmentioning

confidence: 99%

Effect of Radiofrequency Ablation with Interventional Therapy of Hepatic Artery on the Recurrence of Primary Liver Cancer and the Analysis of Influencing Factors

Zhang

Zhao

Dong

2021

Journal of Oncology

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“…Packing the pseudoaneurysm sac with coils is not advisable given the risk of rupture secondary to increased pressure. Coil embolization is generally acceptable in the management of small and/or medium sized vessels, however, pseudoaneurysms that have developed in larger more proximal vessels such as the right hepatic, proper, or common hepatic arteries can be treated with stent graft placement with high success rates (32)(33)(34).…”

Section: Embolization Techniquesmentioning

confidence: 99%

Hepatic trauma

Roberts¹,

Sheth²

2021

Ann Transl Med

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Management of trauma-related liver injury has undergone a paradigm shift over the past four decades. In hemodynamically stable patients, the standard of care in the majority of level-one trauma centers has shifted to nonoperative management with high success rates, especially with low-grade liver injuries (i.e., grade I and II liver injuries). Advances in critical care medicine, cross-sectional imaging, and transarterial embolization techniques have led to the improvement of patient outcomes and decreased mortality rates in patients with arterial injuries. Currently, no consensus guidelines on appropriate patient selection criteria have been published by the Society of Interventional Radiology (SIR) or the American Association for the surgery of Trauma (AAST). Based off the current literature, nonoperative management with hepatic angiography and transarterial embolization (TAE) should be the treatment of choice in hemodynamically stable patients with clinical suspicion of arterial injury. TAE has been shown to improve success rates of nonoperative management and is well tolerated by most patients with low complication rates. Hepatic necrosis is the most common and concerning reported complication but can be reduced with selective approach and choice of embolic agent. The majority of literature supporting the use of TAE for traumarelated liver injury consists of retrospective case series and additional larger scale studies are needed to determine the efficacy of TAE in this setting. However, it is clear from the current literature that hepatic TAE is an effective and safer option to operative management in treating arterial hemorrhage in the setting of traumatic hepatic injury.

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“…In contrast, patient #13 was bleeding from a gallbladder artery after laparoscopic whole-layer cholecystectomy, which was caused by improper sealing of the artery. The recently reported technical and clinical success rates of endovascular management for pseudoaneurysms after abdominal surgery are 95%-100% and 76%-82%, respectively [3] [4] [5]. Kajiwara et al [6] described that the prolonged interval from the onset of bleeding to angiography may cause high mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Muramoto et al [11] and Nakajima et al [10] reported cases of stent-graft placement followed by combination antiplatelet therapy with clopidogrel and aspirin and described the necessity of these antiplatelet therapies. On the other hand, Cui et al [5] described that antithrombotic drugs are not always necessarily because these are not needed in stent-grafts, which are larger in diam-eter. To determine the necessity of antithrombotic therapies, future research with a larger sample size is needed.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Management of Pseudoaneurysms and Aneurysms Following Gastrointestinal Surgery

Kageyama¹,

Yamaguchi²,

Tamai³

et al. 2021

JJGH

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Purpose:This study aimed to evaluate the characteristics of pseudoaneurysms and aneurysms following gastrointestinal surgery treated with endovascular management (i.e., transcatheter arterial embolization or stent-graft placement). Methods:This retrospective study included 17 patients with pseudoaneurysms and 1 patient with an aneurysm following gastrointestinal surgery in a tertiary care hospital between 2011 and 2021. There were 15 men and 3 women aged 37-85 years, with an average age of 67 years. All patients underwent endovascular management. We retrospectively analyzed their angiographic features and clinical outcomes. Results:Arterial embolization was performed in 11 patients, and stent-graft placement was performed in 7 patients. Additional arterial embolization was necessary for another bleeding lesion in 2 patients, while 1 patient died of multiple organ failure. Stent-graft occlusion occurred after a few days in 3 out of 7 patients without any antithrombotic drugs. Extravascular migration of the occluded stentgrafts was observed in 3 out of 7 patients, wherein these stent-grafts migrated to the intestine and eventually disappeared in 2 patients. There were no clinical symptoms related to the occlusion or migration of the stent-grafts. Conclusion:Both arterial embolization and stent-graft place-ment are effective in the management of postoperative pseudoaneurysms and aneurysms. Stent-graft placement is suitable for cases with poor collateral flow because it preserves arterial patency. The use of antithrombotic treatment and the risk of stent-grafts migration should be taken into consideration.

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Covered stent placement for hepatic artery pseudoaneurysm

Cited by 30 publications

References 12 publications

Effect of Radiofrequency Ablation with Interventional Therapy of Hepatic Artery on the Recurrence of Primary Liver Cancer and the Analysis of Influencing Factors

Effect of Radiofrequency Ablation with Interventional Therapy of Hepatic Artery on the Recurrence of Primary Liver Cancer and the Analysis of Influencing Factors

Hepatic trauma

Endovascular Management of Pseudoaneurysms and Aneurysms Following Gastrointestinal Surgery

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