[The surgical and endovascular treatment of the hepatic artery aneurysms: personal experience].
OBJECTIVE
The aim of this single-institution retrospective study is to report the results of surgical and endovascular treatment of hepatic artery aneurysms.


METHODS
Twenty patients with an extraparenchimal hepatic artery aneurysm made part of the study In the first period, between February 1980 and December 1996, 12 patients were admitted and treated surgically. In the second period, January 1997 until December 2005, 8 patients were admitted. Four were treated surgically and 4 with an endovascular procedure. The aneurysms ranged from 2.3 cm to 6.2 cm Seventeen patients were asymptomatic, while three were symptomatic for pain and obstructive icterus. In 13 patients aneurysmectomy and graft interposition was performed, in three patients aneurysmectomy with dacron patch interposition was performed, and in 4 patients the aneurysm was excluded with a stent-graft.


RESULTS
No perioperative mortality was noted and no major complication occurred. All endovascular procedures successfully excluded the aneurysm without signs of endoleak. Follow-up in 4 months, 6 months and 10 months postoperatively showed patency of the stent-graft with no signs of migration or endoleak. Only in one case, in the 8th post-operative month, thrombosis of the stent-graft occurred and the patient was completely asymptomatic.


CONCLUSIONS
The natural history of hepatic artery aneurysms is rupture, and consequently there is an indication of treatment. Actually, we consider endovascular treatment as the first-choice-treatment whenever possible. Endovascularlly treated patients need a strict follow-up surveillance by imaging means. Particular attention so be given in the preoperative study of the collateral circulation in patient treated surgically.
Nano
Giovanni
G
Unità Operativa di Chirurgia Vascolare, Policlinico San Donato - IRCCS, Scuola di Chirurgia Vascolare Università degli studi di Milano. giovanni.nano@libero.it
Dalainas
Ilias
I
Bianchi
Paolo
P
Ciarmoli
Elena
E
Malacrida
Giovanni
G
Ramponi
Fabio
F
Tealdi
Domenico G
DG
D000783:Aneurysm / Q000601:surgery*; D006499:Hepatic Artery; D006801:Humans; D014656:Vascular Surgical Procedures