Hepatic artery aneurysm: factors that predict complications

Abbas, Maher A.; Fowl, Richard J.; Stone, William M.; Panneton, Jean M.; Oldenburg, W. Andrew; Bower, Thomas C.; Cherry, Kenneth J.; Gloviczki, Péter

doi:10.1016/s0741-5214(03)00090-9

Cited by 304 publications

(356 citation statements)

References 17 publications

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“…1,5,8,9 Among the different forms of splanchnic vascular aneurysms, 1,2,4,8-10 only splenic artery aneurysms (60%-75%) are more frequent than HAA. Pseudoaneurysms of hepatic arteries in particular have been increasing in recent decades, and the rate of increase has paralleled the increase in interventional biliary procedures, such as biopsies, and nonoperative liver trauma (such as that caused by car accidents).…”

Section: Discussionmentioning

confidence: 99%

“…Then, in 1903, Kehr reported the first successful hepatic artery ligation to treat a perforation into the gallbladder, which was followed almost 5 decades later, in 1951, by Paul reporting the first successful revascularization surgery. 1,3,4 Since then, many alternative treatment methods have been developed for HAA based on our increased understanding of the etiopathogenesis of HAA, in particular its association with atherosclerosis, medial degeneration, fibromuscular dysplasia, polyarteritis nodosa, tuberculosis, trauma, invasive radiologic interventions, transplantation, and certain inflammatory diseases.…”

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confidence: 99%

“…Rupture develops in 14% to 80% of cases, depending on the diameter of the aneurysmatic segment, location of aneurysm, and other etiologic factors, and when developed, mortality for rupture ranges between 20% and 70%. [1][2][3]5,6 Therefore, despite the lack of a consensus, surgical intervention is recommended for all hepatic artery aneurysms that are symptomatic or .2 cm. The operative approaches, however, may vary according to location, diameter, collateral blood flow, and etiology of the aneurysm.…”

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confidence: 99%

“…The operative approaches, however, may vary according to location, diameter, collateral blood flow, and etiology of the aneurysm. 1,5,7 Embolization, percutaneous transluminal angioplasty/stenting, or surgical repair is widely applied, whereas another less frequent option is excision with splenic artery transposition graft. [1][2][3][4][5][6][7][8][9][10] Here, we present a case of hepatic artery aneurysm that was successfully repaired with splenic artery transposition graft.…”

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confidence: 99%

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Splenic Artery Transposition Graft Usage for the Supply of the Right Hepatic Artery: A Case Report

Odabaşı

Eris

Yıldız

et al. 2013

International Surgery

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Hepatic artery aneurysms are responsible for 12% to 20% of all visceral arterial aneurysms. Because most patients are asymptomatic, this disease is generally diagnosed incidentally during radiologic examination. Aneurysm rupture develops in 14% to 80% of cases, depending on the aneurysmatic segment's diameter and location, as well as other etiologic factors. Mortality rates associated with rupture range between 20% and 70%. Thus, early diagnosis and timely initiation of medical interventions are critical to improve survival rates. Here, we present a male patient, age 69 years, with a hepatic artery aneurysm that was detected incidentally. The 3-cm aneurysm was detected on contrastenhanced computed tomography and extended from the common hepatic artery to the hepatic trifurcation. A laparotomy was performed using a right subcostal incision. After dissection of the hepatoduodenal ligament, the common, right, and left hepatic arteries, as well as the gastroduodenal artery, were suspended separately. Then, the aneurysmatic hepatic artery segment was resected, and the gastroduodenal artery stump was ligated. An end-to-end anastomosis was formed between the left and common hepatic arteries, followed by an end-to-end anastomosis formed between the right hepatic artery and splenic artery using a splenic artery transposition graft. Postoperative follow-up examinations showed that both hepatic arterial circulations were good, and no splenic infraction had developed.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Splenic Artery Transposition Graft Usage for the Supply of the Right Hepatic Artery: A Case Report

Odabaşı

Eris

Yıldız

et al. 2013

International Surgery

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“…5). The reported indications for treatment of common hepatic artery aneurysms are: symptomatic aneurysms, aneurysms larger than 2 cm, non-atherosclerotic aneurysms and multiple aneurysms (9). Surgery and endovascular intervention are the main treatment modalities.…”

Section: Dilatation Of the Hepatic Arterymentioning

confidence: 99%

Pictorial essay: Multidetector CT of hepatic artery pathologies

Karaosmanoğlu

Erol

Karçaaltıncaba

2012

Journal of the Belgian Society of Radiology

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Imaging of the visceral vascular structures non-invasively with the development of MDCT is one of the most important forward leaps in radiology in the last decade. With the improvement of the MDCT technology any arterial and venous vascular structure of the abdomen can be easily detected and treatment planning can be done in a straightforward manner. Compared to conventional catheter angiography, MDCT imaging of the vascular tree is sometimes more contributory to the patient's treatment plan. Pathologies of the hepatic artery are not rare and in some specific situations may be utmost important for the patient's morbidity and even mortality. In this manuscript, we have tried to provide an overview to pathologies of the hepatic artery in terms of MDCT findings. Anatomical variationsExact delineation of the hepatic artery and its branches is a significant factor for the success of liver transplantation, especially for the grafts from living donors. Sufficient arterial flow via the hepatic artery is one of the most important factors for the survival of the graft. MDCT is increasingly being used for the evaluation of the hepatic artery in the pre-transplant phase (1). With the use of the MDCT, other vascular structures related to the liver can artery arising from the left gastric artery and the replaced right hepatic artery from the superior mesenteric artery are the most common arterial variations (i.e. Michel's type II and III, respectively) and may be seen in 10% and 11% of the subjects. Hepatic artery originating directly from the abdominal aorta is an uncommon presentation (0.2-3%) but an important finding for the surgeon (2-4) (Fig. 2). Apart from these anatomical variations, a replaced right hepatic artery can give rise to splenic artery (Fig. 3). For pre-transplant imaging, the calibration of the hepatic arteries may also be easily evaluated. also be quickly examined in a single imaging study within a remarkably short period of time. Michel's classification is the conventional method for the evaluation the vascular variations, and in this system only 55% of the hepatic arteries show the classic branching (1) (Fig. 1). Left hepatic JBR-BTR, 2012, 95: 345-349. The hepatic artery can be involved by a variety of pathology and diseases. Today MDCT enables high quality imaging of the hepatic artery using axial, MIP and volume rendered images. We illustrate MDCT findings of anatomical variations, aneurysm, dilatation, dissection, arteriovenous fistula, thrombosis and stenosis. Aneurysms can be saccular, fusiform and multiple and may develop due to atherosclerosis, vasculitis, trauma and biopsy. Dilatation of hepatic artery can be seen in portal hypertension, Osler-Weber-Rendu disease and hemangiomatosis. Hepatic artery can be occluded after trauma and transplantation. Dissection develops due to atherosclerosis, Marfan and Ehler Danlos syndromes and during pregnancy. Arteriovenous fistula can be congenital and acquired. We conclude that various hepatic artery pathologies can be confidently diagnosed by MDCT. PICTOR...

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