[Hepatic artery aneurysms].
OBJECTIVE
The aim of this retrospective study was to report a series of nine aneurysms of the hepatic arteries, including real aneurysms (n = 4), pseudoaneurysms (n = 3) and false aneurysms (n = 2) observed from 1987 to 1999.


METHODS
There were 7 men and 2 women (mean age: 58 years). In 3 cases, the aneurysm was asymptomatic and detected by sonography; in 4 cases it was revealed by rupture with a severe hemorrhage and in 2 cases by cholestasis. The aneurysm was located on right (n = 3), proper and common (n = 3), proper (n = 2), and common (n = 1) hepatic arteries. The aneurysm was associated with hepatocellular carcinoma (n = 1), carcinoma of the head of the pancreas (n = 1) and liver metastases (n = 1).


RESULTS
Eight patients were operated and one of them was operated three times. Hepatic arterial blood supply was restored in 6 patients with simple suture (n = 1), Goretex graft (n = 2), allograft (n = 2) and autologous vein (n = 1), with one failure which required liver retransplantation. Only one of the three attempts of embolization was successful. One patient with surgical contraindications died from hemobilia after embolization failure. During follow-up, there was one thrombosis of the common hepatic artery which had been excluded and two late deaths: one from rupture of a false aneurysm after bypass with an allograft and one by terminal progression of the cancer. The other 6 patients were alive at the time of this study.


CONCLUSIONS
Clinical characteristics and therapeutic indications of hepatic arterial aneurysm are variable. Management is usually surgical, while embolization is reserved for special circumstances. Restoration of the hepatic arterial blood supply is necessary in aneurysms located on the proper hepatic artery.
Service de chirurgie générale et thoracique, centre hospitalier Lyon-Sud, 69495 Pierre Bénite, France. olivier.glehen@chu-lyon.fr
O
O
Glehen
P
P
Feugier
C
C
Ducerf
J M
JM
Chevalier
J
J
Baulieux
D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D006528:Carcinoma, Hepatocellular / Q000150:complications; D002779:Cholestasis / Q000209:etiology; D004621:Embolization, Therapeutic; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000556:secondary; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome