Iatrogenic dissection of the celiac artery and its branches during transcatheter arterial embolization for hepatocellular carcinoma: outcome in 40 patients.
OBJECTIVE
To study the sequelae of iatrogenic dissection of the celiac axis and its branches in a large patient population.


METHODS
We analyzed 40 patients with hepatocellular carcinoma (HCC) whose celiac artery or its branches were dissected during transcatheter arterial embolization (TAE) and underwent follow-up angiography within 2 months.


RESULTS
The two most common sites of dissection were the celiac artery in 13 patients (32.5%) and the proper hepatic artery in 11 patients (27.5%). Follow-up angiography revealed complete recanalization in 32.5% (13/40), irregularity and narrowing of the lumen in 40% (16/40), and complete obstruction in 27.5% (11/40). Therefore, 72.5% (29/40) of the dissected arteries recanalized. Pseudoaneurysm formation of the dissected artery was observed in 32.5% (13/40). Subsequent TAE was possible via the dissected arteries in 79% (27/34) of patients in this series.


CONCLUSIONS
Iatrogenic dissection of the celiac and proximal hepatic arteries heals spontaneously in the majority of patients, and in most instances allows subsequent TAE.
Yoon
D Y
DY
Department of Radiology, Seoul National University College of Medicine, Korea.
Park
J H
JH
Chung
J W
JW
Han
J K
JK
Han
M C
MC
D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000209:etiology; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000628:therapy; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000293:injuries; D006801:Humans; D007049:Iatrogenic Disease; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D014945:Wound Healing