Giant Hepatic Aneurysm Presenting With Hematemesis Successfully Treated With an Endovascular Technique

Abstract

Hepatic artery aneurysms are uncommon visceral aneurysms that are usually found incidentally on imaging. We present a case of large common hepatic aneurysm presenting with life-threatening hematemesis due to duodenal erosion, in a 66-year-old man, treated by embolization with Onyx and coils while preserving hepatic perfusion.

Open Surgical Repair for a Giant Common Hepatic Artery Aneurysm with Difficulty in Proximal Arterial Clamping: A Case Report

“…8) Large size itself is not a contraindication for endovascular treatment, and favorable results have been reported in patients with giant HAA. 1,2) In this study, we opted for an open surgical repair in this patient as the splenic artery originated just proximal to the aneurysm, and embolization of the celiac axis can occlude the splenic artery. Additionally, there was insufficient information regarding the outflow orifice of the aneurysm.…”

“…Hepatic artery aneurysm (HAA) has been considered to be relatively rare. Although successful endovascular treatment has been reported, 1,2) this approach is not feasible for some patients due to anatomical reasons. 3,4) In such cases, open surgical repair is performed, and control of the proximal blood flow is necessary.…”

Endovascular embolization of a giant hepatic artery aneurysm

“…The natural history of HAAs is poorly understood; however, progressive enlargement is thought to lead to increasing risk of rupture and death. Diagnosis is usually achieved via ultrasound, computed tomography or magnetic resonance angiography …”

“…The current literature suggests repair of HAAs in cases where the aneurysm is greater than 2 cm, as well as all pseudoaneurysms, due to the elevated risk of rupture . Other considerations for intervention include aetiology, symptoms and rate of growth …”

“…The technical success of endovascular repair of HAAs is very high, up to 98% in some reports . Potential complications include hepatic infarction, dissection, thromboembolic events, pseudoaneurysms and contrast‐induced nephropathy . Shukla et al .…”