Endovascular Treatment of a Huge Hepatic Artery Aneurysm by Coil Embolization Method: A Case Report

Combined Endovascular Repair of a Giant Symptomatic Hepatic Aneurysm: A Case Report and Comprehensive Literature Review

Hepatic artery aneurysms (HAAs) are an uncommon vascular disease, which account for 20% of visceral artery aneurysms. The majority are usually asymptomatic and discovered accidentally during imaging control, but occasionally, they can present as acute abdominal pain, haemobilia, obstructive jaundice, or gastrointestinal bleeding due to aneurysm sac expansion or rupture with catastrophic consequences. We present the case of a 51-year-old male patient with a giant common HAA of 11.1 cm who was managed endovascularly. A combined endovascular approach was decided due to the anatomy of the aneurysm. Endovascular embolization with coils in the distal part of the aneurysm and deployment of a stent graft proximally to exclude inflow were used. At six months, the aneurysm size was regressed at 5 cm; however, seven months after the operation, the patient presented with pylorus perforation due to coil migration which was managed by coil removal, peripheral gastrectomy, and Roux-en-Y gastric bypass. We provide a narrative literature review regarding the endovascular repair of giant HAAs. The PubMed, Scopus, and Google Scholar databases were searched for articles up to January 2024. Thirty-eight studies (case reports, case series) were retrieved. The conclusion is that giant HAAs are a rare and severe condition in which their treatment can be challenging with unexpected adverse events. The literature review suggests that the endovascular approach whenever feasible is a safe and effective treatment option with low morbidity and mortality.

Circulating non-coding RNAs as potential diagnostic biomarkers in liver diseases

The liver plays a principal role in the human body as a metabolic and detoxifying unit. Liver diseases are the world's major health problems and affect millions of people worldwide. Early detection of liver diseases is certainly effective in timely treatment and prevention of their progression. Liver injury is associated with significant alterations in immune responses and pattern changes in various tissue-related gene expressions and cytokine production. Increasing or decreasing the specific spectrum of non-coding RNAs in different phases of liver disease can be a criterion for diagnosis. Novel diagnostic biomarkers are needed for liver diseases. Currently, micro-RNAs (miRNAs) are known to play important roles in the diagnosis of liver diseases. Circulating biomarkers such as miRNA-assisted diagnosis can conceivably be helpful for the early treatment of liver diseases. In this review, we look at miRNAs and their potential applications in liver diseases as diagnostic biomarkers were investigated.

Successful Endovascular Treatment of a Giant Hepatic Artery Aneurysm with Dual Layer Stents Placement as Flow-Diverting Option: Case Report

BACKGROUND:

Visceral artery aneurysms are rare conditions. The incidence of hepatic artery aneurysm (HAA) accounts for approximately 20% of all splanchnic aneurysms. HAA can become a life-threatening situation because there is a great risk of rupture when it grows more than 2 cm in diameter.

CASE PRESENTATION:

In this article, we describe a case of a 54-year-old female patient with large hepatic artery aneurysm which was incidentally founded. From symptoms, she had abdominal discomfort slightly worsening after meals, frequent pain in mesogastrium and reported some unexplained weight loss in the last few months. The lesion was detected by CT examination of the abdomen and pelvis.

CONCLUSION:

The aneurysm was successfully treated at our department with the endovascular approach, by covering the aneurysmal sac with two stents, one closed cell and one double-layer micromesh new generation stent as a flow diverting option..