title: Stent graft placement for postsurgical hemorrhage from the hepatic artery: clinical outcome and CT findings.
abstract: OBJECTIVE
  To evaluate the clinical results and imaging follow-up findings of stent grafts placed for hemorrhage from hepatic arteries following surgery.
  
  
  METHODS
  The investigation included 17 patients (14 men and 3 women) who underwent endovascular stent graft placement for hepatic arterial hemorrhage following surgery. Bleeding occurred from the common hepatic artery (n = 1; 6%), right hepatic artery (n = 1; 6%), proper hepatic artery (n = 6; 35%), and gastroduodenal artery stump (n = 9; 53%). Stent graft patency, thrombus at the graft, target hepatic artery diameter, and liver perfusion status were analyzed by comparing computed tomography (CT) scans performed before the procedure with follow-up CT scans. Laboratory data were also analyzed before the procedure and at follow-up intervals.
  
  
  RESULTS
  There were 17 stent grafts placed in 17 patients. The mean follow-up period was 356 days (range, 1-2,119 d). The stent graft primary patency rate was 79.5% at 1 month, 69.6% at 6 months, and 69.6% at 1 year. The clinical success rate was 82% (14 of 17 patients), and the technical success rate was 94% (16 of 17 patients). Mortality related to the stent graft was 12% (2 of 17 patients). Occlusion occurred in 4 of 16 stent grafts (25%). There was one technical failure. The mean stent graft diameter was 6.2 mm (range, 3.5-8.0 mm), and the degree of stent graft oversizing was 38% of the hepatic artery diameter on CT scans and 58% on angiography. Hepatic parenchymal perfusion was preserved in 80% of patients (12 of 15).
  
  
  CONCLUSIONS
  Hepatic artery hemorrhage following surgery can be treated effectively with stent graft placement.
authors.affiliation: Department of Radiology, Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, 135-710, Irwon-Dong, Gangnam Gu, Seoul, Korea.
authors.forename: Seong Joo
authors.initials: SJ
authors.lastname: Lim
authors.affiliation: Department of Radiology, Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, 135-710, Irwon-Dong, Gangnam Gu, Seoul, Korea. Electronic address: kbjh.park@samsung.com.
authors.forename: Kwang Bo
authors.initials: KB
authors.lastname: Park
authors.affiliation: Department of Radiology, Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, 135-710, Irwon-Dong, Gangnam Gu, Seoul, Korea.
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Hyun
authors.affiliation: Department of Radiology, Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, 135-710, Irwon-Dong, Gangnam Gu, Seoul, Korea.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Do
authors.affiliation: Department of Radiology, Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, 135-710, Irwon-Dong, Gangnam Gu, Seoul, Korea.
authors.forename: Hong Suk
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Radiology, Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, 135-710, Irwon-Dong, Gangnam Gu, Seoul, Korea.
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Shin
authors.affiliation: Department of Radiology, Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, 135-710, Irwon-Dong, Gangnam Gu, Seoul, Korea.
authors.forename: Sung Ki
authors.initials: SK
authors.lastname: Cho
authors.affiliation: Division of Hepato-Biliary and Pancreas, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, 135-710, Irwon-Dong, Gangnam Gu, Seoul, Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Choi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008102:Liver Circulation; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013927:Thrombosis / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: DIC; disseminated intravascular coagulation