title: Successful treatment of a common hepatic artery pseudoaneurysm using a coronary covered stent following pancreatoduodenectomy: report of a case.
abstract: This report presents the case of a common hepatic artery (CHA) pseudoaneurysm secondary to postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD), which was successfully treated using a coronary covered stent. A 70-year-old female underwent subtotal stomach-preserving PD for middle cholangiocarcinoma. POPF was identified on postoperative day (POD) 7, and the patient suddenly lost 500 ml of blood via the abdominal drain on POD 19. Urgent celiac arteriography revealed a CHA pseudoaneurysm. A coronary covered stent was placed to prevent rupture of the pseudoaneurysm and to maintain hepatic arterial flow, instead of performing transarterial embolization. No vascular adverse events were encountered during or after the procedure. Computed tomography and angiography showed a patent stent graft and good hepatic arterial flow 9 months after placement of the stent. Endovascular stent-graft placement not only treated the pseudoaneurysm, but also preserved the arterial blood flow. This report describes the placement of a covered stent graft for delayed hemorrhage after PD.
authors.affiliation: Department of Surgery, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan, k-asai@mvg.biglobe.ne.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Asai
authors.forename: Manabu
authors.initials: M
authors.lastname: Watanabe
authors.forename: Shinya
authors.initials: S
authors.lastname: Kusachi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsukiyo
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Saito
authors.forename: Hajime
authors.initials: H
authors.lastname: Kodama
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Enomoto
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Saida
authors.forename: Raisuke
authors.initials: R
authors.lastname: Iijima
authors.forename: Jiro
authors.initials: J
authors.lastname: Nagao
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000209:etiology / Q000601:surgery*; D017542:Aneurysm, Ruptured / Q000517:prevention & control; D001650:Bile Duct Neoplasms / Q000601:surgery; D018281:Cholangiocarcinoma / Q000601:surgery; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006499:Hepatic Artery / Q000502:physiology; D006801:Humans; D008102:Liver Circulation; D010185:Pancreatic Fistula / Q000209:etiology; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000209:etiology; D015607:Stents; D016896:Treatment Outcome