Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
Department of General, Visceral, and Transplantation Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
Cardiovasc Intervent Radiol. 2022 Jan;45(1):21-28. doi: 10.1007/s00270-021-02993-0. Epub 2021 Nov 3.
To investigate efficacy and patency status of stent graft implantation in the treatment of hepatic artery pseudoaneurysm.
A retrospective analysis of patients who had undergone endovascular treatment of hepatic artery pseudoaneurysms between 2011 and 2020 was performed. Medical records were examined to obtain patients' surgical histories and to screen for active bleeding. Angiographic data on vascular access, target vessel, material used and technical success, defined as the exclusion of the pseudoaneurysm by means of a stent graft with sufficient control of bleeding, were collected. Vessel patency at follow-up CT was analyzed and classified as short-term (< 6 weeks), mid-term (between 6 weeks and 1 year), and long-term patency (> 1 year). In case of stent occlusion, collateralization and signs of hepatic hypoperfusion were examined.
In total, 30 patients were included and of these, 25 and 5 had undergone stent graft implantation and coiling, respectively. In patients with implanted stent grafts, technical success was achieved in 23/25 patients (92%). Follow-up CT scans were available in 16 patients, showing stent graft patency in 9/16 patients (56%). Short-term, mid-term, and long-term short-term stent patency was found in 81% (13/16), 40% (4/10), and 50% (2/4). In patients with stent graft occlusion, 86% (6/7) exhibited maintenance of arterial liver perfusion via collaterals and 14% (1/7) exhibited liver abscess during follow-up.
Stent graft provides an effective treatment for hepatic artery pseudoaneurysms. Even though patency rates decreased as a function of time, stent occlusion was mainly asymptomatic due to sufficient collateralization.
研究支架植入治疗肝动脉假性动脉瘤的疗效和通畅情况。
对 2011 年至 2020 年间接受血管内治疗的肝动脉假性动脉瘤患者进行回顾性分析。检查病历以获取患者的手术史并筛查活动性出血。收集血管入路、靶血管、使用的材料和技术成功的血管造影数据，定义为通过支架移植物充分控制出血排除假性动脉瘤。分析并分类随访 CT 时的血管通畅情况为短期（<6 周）、中期（6 周至 1 年之间）和长期通畅（>1 年）。如果支架闭塞，检查侧支循环和肝灌注不足的迹象。
共纳入 30 例患者，其中 25 例和 5 例分别接受了支架植入和线圈治疗。在植入支架的患者中，23/25 例（92%）患者技术成功。16 例患者进行了随访 CT 扫描，显示 9/16 例（56%）支架移植物通畅。短期、中期和长期支架通畅率分别为 81%（13/16）、40%（4/10）和 50%（2/4）。在支架闭塞的患者中，86%（6/7）通过侧支循环维持了肝动脉灌注，14%（1/7）在随访中出现了肝脓肿。
支架植入是治疗肝动脉假性动脉瘤的有效方法。尽管随着时间的推移通畅率下降，但由于充分的侧支循环，支架闭塞主要是无症状的。
