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O'Connell JL, Faria LAO, de Souza MG, Meneses GA, Carrijo AMM. Endovascular treatment of an asymptomatic hepatic artery aneurism: case report. J Vasc Bras 2021; 20:e20200123. [PMID: 34456983 PMCID: PMC8366405 DOI: 10.1590/1677-5449.200123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 01/10/2021] [Indexed: 11/24/2022] Open
Abstract
We report a case of an asymptomatic, 77-year-old, male patient with arterial hypertension and no other comorbidities or risk factors for coronary disease. During a routine abdominal ultrasound examination, he was diagnosed with a hepatic vascular mass with an approximate diameter of 5 cm. Abdominal computed angiotomography was requested, showing an aneurysm of the hepatic artery, with maximum diameter of up to 5.2 cm, longest longitudinal axis of 7.2 cm, and a maximum true lumen caliber of 3.0 cm. We opted for endovascular aneurysm repair with implantation of three sequential Lifestream covered vascular stents (7x58mm, 8x58mm, and 8x37mm), successfully diverting the flow through the stents and excluding the aneurysm. The patient remains asymptomatic and free from clinical complications 2 years after the procedure. Control examinations with arterial duplex ultrasound 6 and 12 months after the procedure showed good flow through the stents with no leakage into the aneurysmal sac.
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Affiliation(s)
- João Lucas O'Connell
- Universidade Federal de Uberlândia - UFU, Faculdade de Medicina - FAMED, Uberlândia, MG, Brasil
| | | | - Marcela Gomes de Souza
- Universidade Federal de Uberlândia - UFU, Faculdade de Medicina - FAMED, Uberlândia, MG, Brasil
| | - Gabriel Alves Meneses
- Universidade Federal de Uberlândia - UFU, Faculdade de Medicina - FAMED, Uberlândia, MG, Brasil
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Karaosmanoglu AD, Uysal A, Akata D, Ozmen MN, Karcaaltincaba M. Role of imaging in visceral vascular emergencies. Insights Imaging 2020; 11:112. [PMID: 33057847 PMCID: PMC7561664 DOI: 10.1186/s13244-020-00913-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/14/2020] [Indexed: 02/07/2023] Open
Abstract
Differential diagnosis in non-traumatic acute abdomen is broad and unrelated diseases may simulate each other from a clinical perspective. Despite the fact that they are not as common, acute abdominal pain due to diseases related to visceral vessels may be life-threating if not detected and treated promptly. Thrombosis, dissection, and aneurysm in the abdominal visceral arteries or thrombosis in visceral veins may cause acute abdominal pain. Imaging with appropriate protocoling plays a fundamental role in both early diagnosis and determination of the treatment approach in these cases where early treatment can be life-saving. Computed tomography (CT) appears to be the most effective modality for the diagnosis as it provides high detail images in a very short time. Patient cooperation is also a less concern as compared to magnetic resonance imaging (MRI). As the imaging findings may sometimes be really subtle, diagnosis may be difficult especially to inexperienced imagers. Correct protocoling is also very critical to detect arterial abnormalities as visceral arterial abnormalities may not be detectable in portal phase only abdominal CT scans. In this article, we aimed to increase awareness among imaging specialists to these not very common causes of acute abdomen.
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Affiliation(s)
| | - Aycan Uysal
- Department of Radiology, Gulhane Training and Research Hospital, 06010, Ankara, Turkey
| | - Deniz Akata
- Department of Radiology, Hacettepe University School of Medicine, 06100, Ankara, Turkey
| | - Mustafa Nasuh Ozmen
- Department of Radiology, Hacettepe University School of Medicine, 06100, Ankara, Turkey
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Ohanisian L, Rubay D, Morrow ML, Basich G, Lopez-Viego M. Hepatic Artery Aneurysm in the Setting of Acute Pancreatitis and Giant Cell Arteritis. Cureus 2019; 11:e5410. [PMID: 31511814 PMCID: PMC6716759 DOI: 10.7759/cureus.5410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Visceral artery aneurysms are rare with an incidence of 0.1%-0.2%. Of these, 20% are hepatic artery aneurysms (HAAs). Despite the potential of remaining asymptomatic for long periods of time, the risk of rupture for HAAs is 20%-80%. Treatment includes operative management with open or endovascular techniques. HAA in the setting of pancreatitis has been reported in two prior cases outside of the United States. However, there have been no cases describing the association of HAA and giant cell arteritis (GCA). We present a rare case of an 80-year-old male with a history of GCA who was found to have developed HAA following an episode of acute pancreatitis that was repaired surgically with an open technique. To our knowledge, the association between HAA with acute pancreatitis and GCA has not been reported before.
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Affiliation(s)
- Levonti Ohanisian
- Orthopaedic Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, USA
| | - David Rubay
- Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, USA
| | - Megan L Morrow
- Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, USA
| | - Garrett Basich
- Miscellaneous, St. Mary's College of California, Moraga, USA
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Masuda K, Takenaga S, Morikawa K, Ashida H, Ojiri H. A case of giant common hepatic artery aneurysm successfully treated by transcatheter arterial embolization with isolation technique via pancreaticoduodenal arcade. Radiol Case Rep 2018; 14:195-199. [PMID: 30425773 PMCID: PMC6231296 DOI: 10.1016/j.radcr.2018.10.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/22/2018] [Accepted: 10/26/2018] [Indexed: 12/27/2022] Open
Abstract
Hepatic artery aneurysms are rare and sometimes life-threating. Various treatments for hepatic artery aneurysms, including surgical and endovascular techniques are present. Here, we report the case of a 68-year-old woman who presented with an about 9 cm of common hepatic artery aneurysm detected during a routine medical checkup; she did not exhibit any symptoms. We successfully treated the aneurysm with transcatheter arterial embolization with isolation technique via pancreatic duodenal arcade.
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Affiliation(s)
- Koichi Masuda
- Department of Radiology, The Jikei University Katsushika Medical Center, 6-41-2, Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Shinsuke Takenaga
- Department of Radiology, The Jikei University Katsushika Medical Center, 6-41-2, Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Kazuhiko Morikawa
- Department of Radiology, The Jikei University Katsushika Medical Center, 6-41-2, Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Hirokazu Ashida
- Department of Radiology, The Jikei Medical University Hosipital, 3-25-8, Nishishinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Hiroya Ojiri
- Department of Radiology, The Jikei Medical University Hosipital, 3-25-8, Nishishinbashi, Minato-ku, Tokyo 105-8461, Japan
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Bacalbasa N, Brezean I, Anghel C, Barbu I, Pautov M, Balescu I, Brasoveanu V. Successful Resection and Vascular Ligation of a Large Hepatic Artery Aneurysm - A Case Report and Literature Review. ACTA ACUST UNITED AC 2018; 31:979-982. [PMID: 28882969 DOI: 10.21873/invivo.11157] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 08/02/2017] [Accepted: 08/08/2017] [Indexed: 02/06/2023]
Abstract
The occurrence of hepatic artery aneurysms is rare and might be incidentally diagnosed, as the patient remains asymptomatic for a long period of time. However, due to the fact that these lesions are associated with a high risk of developing life threatening complications, such as intraperitoneal rupture, it has been stated that all cases should be submitted to treatment by endovascular or surgical approach. We present the case of a 68-year-old patient, who presented with recurrent upper digestive tract bleedings and was diagnosed with a large aneurysm of the common and the proper hepatic artery, and the gastroduodenal artery. The preoperative angiography revealed an anatomic variation consisting of the common hepatic artery originating from the celiac trunk, and the left hepatic artery originating from the left gastric artery. A percutaneous right portal vein embolization was performed in order to induce hypertrophy of the left lobe and prepare the patient for a right hepatectomy and aneurysmal resection. However, at the time of surgery, after performing the aneurysmal resection and arterial ligation, the vascular supply of the entire liver was efficiently provided by the left hepatic artery and its collaterals. Concluding, hepatic resection was no longer necessary.
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Affiliation(s)
- Nicolae Bacalbasa
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Iulian Brezean
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania .,"Ion Cantacuzino" Clinical Hospital, Bucharest, Romania
| | - Claudiu Anghel
- "Dan Setlacec" Center of Gastrointestinal Disease and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | - Ion Barbu
- "Dan Setlacec" Center of Gastrointestinal Disease and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | - Mihai Pautov
- "Dan Setlacec" Center of Gastrointestinal Disease and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | | | - Vladislav Brasoveanu
- "Dan Setlacec" Center of Gastrointestinal Disease and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania
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Abdallah FF, Serracino-Inglott F, Ananthakrishnan G. Giant Hepatic Aneurysm Presenting With Hematemesis Successfully Treated With an Endovascular Technique. Vasc Endovascular Surg 2017; 51:331-334. [PMID: 28478708 DOI: 10.1177/1538574417707145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hepatic artery aneurysms are uncommon visceral aneurysms that are usually found incidentally on imaging. We present a case of large common hepatic aneurysm presenting with life-threatening hematemesis due to duodenal erosion, in a 66-year-old man, treated by embolization with Onyx and coils while preserving hepatic perfusion.
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Affiliation(s)
- Feras F Abdallah
- 1 Regional Vascular and Endovascular Unit, Central Manchester University Hospital Foundation Trust, Manchester, United Kingdom
| | - Ferdinand Serracino-Inglott
- 1 Regional Vascular and Endovascular Unit, Central Manchester University Hospital Foundation Trust, Manchester, United Kingdom
| | - Ganapathy Ananthakrishnan
- 2 Department of Radiology, Central Manchester University Hospital Foundation Trust, Manchester, United Kingdom
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Cavalcante RN, Couto VAP, da Fonseca AV, de Miranda RB, Costa AJV, Correa JA. Endovascular treatment of a giant hepatic artery aneurysm with Amplatzer vascular plug. J Vasc Surg 2014; 60:500-2. [DOI: 10.1016/j.jvs.2013.06.077] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 06/27/2013] [Accepted: 06/27/2013] [Indexed: 10/26/2022]
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