Lü Peng-Hua, Zhang Xi-Cheng, Wang Li-Fu, Chen Zhao-Lei, Shi Hai-Bin
1Department of Radiology, First Hospital Affiliated to Nanjing University, Nanjing, China.
Vasc Endovascular Surg. 2013 Oct;47(7):551-4. doi: 10.1177/1538574413488460.
The purpose of our study was to evaluate the technical feasibility, procedural complications, clinical follow-up, and computed tomography (CT) scan outcomes of hepatic artery pseudoaneurysms (HAPs) treated with stent graft.
Between October 2004 and October 2009, we treated 8 patients with HAPs with stent graft.
Stent graft deployment was technically successful in all the patients. Complete exclusion of the pseudoaneurysm preserving patency of the hepatic artery was achieved in 6 patients. Total occlusion of the common hepatic artery was observed in 1 patient, and vasospasm of proper hepatic artery and endoleak from distal stent margin were observed in another patient. The 2 patient were controlled through occlusion parent artery with coils. After these procedures, symptoms of bleeding and abdominal pain disappeared. Follow-up enhanced CT scan was performed at an average of 14 months (range, 6-26 months), which showed complete disappearance of the HAP and patency of the stent without intrastent stenosis in 6 patients who had successful deployment of the stent.
Endovascular treatment of HAPs using stent graft can maintain the hepatic artery blood flow and could be considered as an alternative to embolization.
我们研究的目的是评估使用覆膜支架治疗肝动脉假性动脉瘤(HAPs)的技术可行性、手术并发症、临床随访以及计算机断层扫描(CT)扫描结果。
在2004年10月至2009年10月期间,我们使用覆膜支架治疗了8例HAPs患者。
所有患者覆膜支架置入在技术上均获成功。6例患者实现了假性动脉瘤的完全封堵且肝动脉保持通畅。1例患者肝总动脉完全闭塞,另1例患者肝固有动脉出现血管痉挛且远端支架边缘出现内漏。这2例患者通过用弹簧圈封堵供血动脉得到控制。这些操作后,出血和腹痛症状消失。平均在14个月(范围6 - 26个月)时进行了随访增强CT扫描,结果显示6例成功置入支架的患者中,HAP完全消失,支架通畅且无支架内狭窄。
使用覆膜支架对HAPs进行血管内治疗可维持肝动脉血流,可被视为栓塞治疗的一种替代方法。