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采用重叠锥形覆膜支架技术修复复发性肝动脉假性动脉瘤

Recurrent hepatic artery pseudoaneurysm repair with overlapping tapered stent-graft technique.

作者信息

Brahmbhatt Sneh, Acosta Luis F, Gabriel Gaby, Raissi Driss

机构信息

Interventional Radiology, University of Kentucky College of Medicine, 800 Rose street, Lexington, KY 40536, USA.

出版信息

Radiol Case Rep. 2023 Oct 17;18(12):4537-4543. doi: 10.1016/j.radcr.2023.09.038. eCollection 2023 Dec.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e859/10587672/06c4046422d2/gr1.jpg

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