title: Hepatic artery pseudoaneurysm treated using stent-graft implantation and retrograde gastroduodenal artery coil embolization.
abstract: Endovascular treatment options for visceral artery pseudoaneurysms depend on lesion location and size. Exclusion methods fall into two categories, embolization and stent placement, and these procedures aim to exclude the pseudoaneurysm from the circulation and if possible to maintain distal blood flow. Embolization of the afferent artery can be used in pseudoaneurysms that arise from a donor artery without collateral supply such as a visceral branch, whereas in the case of visceral arteries with well-established collateral supply, the embolization of both proximal and distal branches to the pseudoaneurysm is mandatory in preventing backflow from the collateral circulation. A direct embolization delivering coils or glue into the sac can also be performed if the aneurismal neck is narrow. Stent-graft placement represents another option to exclude the pseudoaneurysm, in the case of wide neck, reduced arterial tortuosity and large-diameter arteries. We present a case of common hepatic artery pseudoaneurysm involving the gastroduodenal artery origin treated by a combination of techniques. An hepatic stent-graft implantation plus retrograde embolization of the gastroduodenal artery through the pancreaticoduodenal anastomosis from the superior mesenteric artery was performed.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Ospedale Ferrarotto, Catania, Italy. antodoc@yahoo.com
authors.forename: Antonio
authors.initials: A
authors.lastname: Basile
authors.forename: Salvatore
authors.initials: S
authors.lastname: Ragazzi
authors.forename: Diego
authors.initials: D
authors.lastname: Piazza
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tsetis
authors.forename: Tommaso
authors.initials: T
authors.lastname: Lupattelli
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Patti
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis* / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome; D014463:Ultrasonography