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肝移植术后肝动脉假性动脉瘤的血管内治疗

Endovascular treatment for pseudoaneurysms arising from the hepatic artery after liver transplantation.

作者信息

Thorat Ashok, Lee Chen-Fang, Wu Tsung-Han, Pan Kuang-Tse, Chu Sung-Yu, Chou Hong-Shiue, Chan Kun-Ming, Wu Ting-Jung, Lee Wei-Chen

机构信息

Chang-Gung Transplantation Institute, Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.

Chang-Gung Transplantation Institute, Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.

出版信息

Asian J Surg. 2017 May;40(3):227-231. doi: 10.1016/j.asjsur.2014.07.001. Epub 2014 Aug 30.

Abstract

Hepatic artery pseudoaneurysm after liver transplantation is an uncommon but potentially lethal complication. Early diagnosis and treatment are essential to avoid life-threatening hemorrhage in these patients. We herein report the case of three patients who developed hepatic artery pseudoaneurysms after living donor liver transplantation. Two patients presented with massive duodenal bleeding secondary to erosion of the hepatic artery into the bile duct, and one patient presented with intra-abdominal bleeding. These patients were managed by catheter-based minimal invasive endovascular procedures including coil embolization and stent grafting. All the patients were treated successfully with uneventful recovery. This technique can be considered as an effective treatment option for hepatic artery pseudoaneurysms instead of a difficult surgical intervention.

摘要

肝移植术后肝动脉假性动脉瘤是一种罕见但可能致命的并发症。早期诊断和治疗对于避免这些患者发生危及生命的出血至关重要。我们在此报告3例活体肝移植术后发生肝动脉假性动脉瘤的病例。2例患者因肝动脉侵蚀胆管继发大量十二指肠出血,1例患者出现腹腔内出血。这些患者通过基于导管的微创血管内介入治疗,包括弹簧圈栓塞和覆膜支架植入术进行治疗。所有患者均成功治疗,恢复顺利。该技术可被视为肝动脉假性动脉瘤的有效治疗选择,而非困难的外科干预。

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