Emergency percutaneous treatment in iatrogenic hepatic arterial injuries.
The purpose of this report is to present our experience in the emergency percutaneous treatment of patients with iatrogenic hepatic arterial injury (IHAI). Seven patients (six men, one woman; age range 19-78 years; mean age 63 years) with IHAI secondary to surgical or percutaneous procedures were treated with endovascular percutaneous procedures. We performed six transhepatic arterial embolization (TAE) and one placement of an endograft stent. Follow-up was carried out by ultrasound (US) or computed tomography (CT) after 1, 3, 6, and 12 months, yearly thereafter and by laboratory tests in the first 6 months to completely exclude occult and asymptomatic bleeding. All procedures had 100% technical success. No case of further bleeding was seen at follow-up. In one patient, we detected one abscess after 3 weeks, which was treated by antibiotic therapy. In conclusion, endovascular treatment currently represents a valid option in emergency settings, as it the enables diagnosis and treatment of IHAI in a single session.
Carrafiello
Gianpaolo
G
Department of Radiology, University of Insubria, 21100, Varese, Italy.
Laganà
Domenico
D
Dizonno
Massimiliano
M
Cotta
Elisa
E
Ianniello
Andrea
A
Fugazzola
Carlo
C
D000328:Adult; D000368:Aged; D000792:Angiography; D004621:Embolization, Therapeutic / Q000379:methods; D004638:Emergency Treatment / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D006499:Hepatic Artery / Q000293:injuries*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography