Brahmbhatt Sneh, Acosta Luis F, Gabriel Gaby, Raissi Driss
Interventional Radiology, University of Kentucky College of Medicine, 800 Rose street, Lexington, KY 40536, USA.
Radiol Case Rep. 2023 Oct 17;18(12):4537-4543. doi: 10.1016/j.radcr.2023.09.038. eCollection 2023 Dec.
Hepatic artery pseudoaneurysms (HAPs) are rare but life-threatening complications associated with hepatic artery infusion pump (HAIP) therapy for unresectable liver metastases. Traditional management options include open surgery or stent placement, but these approaches have drawbacks. We present a unique case of a dislodged stent embedded in a HAP, resulting in delayed type-I endoleak. To address this, we employed a novel technique using multiple overlapping tapered stents to reconstruct the hepatic artery. This approach successfully excluded the pseudoaneurysm without endoleak. Stent-graft placement emerges as a safer and more effective option for managing HAP, preserving hepatic arterial flow, and reducing morbidity compared to other methods. However, further research is needed to evaluate this technique's long-term outcomes and potential complications.
肝动脉假性动脉瘤（HAPs）是与不可切除肝转移瘤的肝动脉灌注泵（HAIP）治疗相关的罕见但危及生命的并发症。传统的治疗选择包括开放手术或支架置入，但这些方法存在缺点。我们报告了一例独特的病例，一枚移位的支架嵌入肝动脉假性动脉瘤中，导致延迟性I型内漏。为解决这一问题，我们采用了一种新技术，使用多个重叠的锥形支架重建肝动脉。该方法成功排除了假性动脉瘤且无内漏。与其他方法相比，覆膜支架置入术是治疗肝动脉假性动脉瘤、保留肝动脉血流并降低发病率的更安全、更有效的选择。然而，需要进一步研究来评估该技术的长期疗效和潜在并发症。
