Division of Vascular Surgery, Department of Surgery, Tohoku University Hospital, Sendai, Japan.
Division of Vascular Surgery, Department of Surgery, Tohoku University Hospital, Sendai, Japan.
Ann Vasc Surg. 2022 Jul;83:379.e1-379.e5. doi: 10.1016/j.avsg.2022.03.011. Epub 2022 Mar 23.
Hepatic artery aneurysms (HAAs) complicating autosomal dominant polycystic kidney disease (ADPKD) are extremely rare. On account of the large number of renal cysts in ADPKD, ingenuity is required to safely perform surgery for HAA. Here, we present the case of a 60-year-old man with a common and proper HAA of >60 mm complicated with ADPKD. In this patient, difficulty in maintaining the field of view was expected during surgery. Hence, we performed a hybrid approach with celiac-to-right hepatic artery bypass by puncturing the femoral artery and cannulating the splenic artery to allow celiac-splenic artery balloon occlusion in case of rupture. More than 5 years postoperatively, the graft is patent without intervention.
肝动脉瘤（HAA）并发常染色体显性多囊肾病（ADPKD）极为罕见。由于 ADPKD 中有大量的肾囊肿，因此需要巧妙地进行 HAA 手术。在此，我们介绍了一位 60 岁男性的病例，他患有直径大于 60mm 的常见肝固有动脉瘤，并伴有 ADPKD。在该患者中，预计手术过程中难以维持视野。因此，我们采用了经股动脉穿刺并插管脾动脉的杂交方法进行腹腔动脉到右肝动脉旁路术，以便在破裂时进行腹腔动脉-脾动脉球囊闭塞。术后 5 年以上，移植物无需干预仍保持通畅。
