Successful endovascular embolization of the common hepatic artery for pseudoaneurysm associated with pancreatic fistula after liver transplantation: a case report

Springer Science and Business Media LLC - Tập 9 Số 1 - Trang 1-8 - 2023
Sasaki, Kazuki1, Asaoka, Tadafumi1,2, Kobayashi, Shogo1, Iwagami, Yoshifumi1, Yamada, Daisaku1, Tomimaru, Yoshito1, Noda, Takehiro1, Wada, Hiroshi1,3, Gotoh, Kunihito1,4, Takahashi, Hidenori1, Maeda, Noboru5, Kimura, Yasushi6, Ono, Yusuke6, Doki, Yuichiro1, Eguchi, Hidetoshi1
1Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
2Department of Gastroenterological Surgery, Osaka Police Hospital, Osaka, Japan
3Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
4Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
5Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan
6Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Japan

Tóm tắt

After orthotopic liver transplantation (OLT), complications such as hepatic artery stenosis, thrombosis, and bleeding are possible. Hepatic artery pseudoaneurysms (HAP) are prone to rupture, rupture hemorrhage, and increased mortality risk. Endovascular treatment of HAP may result in recurrence, even after successful embolization with thrombin. Formation of a HAP in the common hepatic artery (CHA) is challenging because the CHA is the only artery in the liver graft after OLT. Therefore, CHA embolization in HAP is not an initial option. We report a case of HAP at the CHA after OLT that was treated with endovascular therapy, resulting in the occlusion of the CHA with coil embolization, achieving a radical cure. A 59-year-old man with decompensated hepatitis C virus cirrhosis underwent deceased donor whole-liver transplantation after graft failure of a living donor liver transplantation. After the second transplantation, the patient developed infectious narrow-necked HAP at the CHA associated with postoperative pancreatic fistula. Repeated transcatheter arterial embolization with thrombin and n-butyl-2-cyanoacrylate was unsuccessful, as confirmed by postprocedure angiography, which revealed recanalization and regrowth of the HAP. Eight months after the first transcatheter arterial embolization, the patient presented with a chief complaint of abdominal pain due to an enlarged HAP. Angiography of the superior mesenteric artery (SMA) revealed a collateral bypass around the bile duct from the SMA to the liver graft. Coil embolization of the HAP in the CHA completely occluded the HAP without complications. More than 2 years after coil embolization, the liver graft function test results remained within normal limits without HAP recurrence. HAP at the CHA after liver transplantation can be fatal if ruptured. Because the liver is a highly angiogenic organ, even if initial treatment is not successful, radical treatment to occlude the CHA with HAP is possible if sufficient collateral vessels are developed.

Tài liệu tham khảo

Japanese Liver Transplantation Society. Liver Transplantation in Japan—Registry by the Japanese Liver Transplantation Society. Available from: http://jlts.umin.ac.jp/ . citation_journal_title=Clin Radiol; citation_title=Hepatic artery pseudoaneurysms following liver transplantation: incidence, presenting features and management; citation_author=MM Marshall, P Muiesan, P Srinivasan, PA Kane, M Rela, ND Heaton; citation_volume=56; citation_publication_date=2001; citation_pages=579-587; citation_doi=10.1053/crad.2001.0650; citation_id=CR2 citation_journal_title=Cardiovasc Intervent Radiol; citation_title=Extrahepatic pseudoaneurysms and ruptures of the hepatic artery in liver transplant recipients: endovascular management and a new iatrogenic etiology; citation_author=WE Saad, N Dasgupta, AJ Lippert, UC Turba, MG Davies, S Kumer; citation_volume=36; citation_publication_date=2013; citation_pages=118-127; citation_doi=10.1007/s00270-012-0408-y; citation_id=CR3 citation_journal_title=Ann Transplant; citation_title=Preservation of the arterial vascularisation after hepatic artery pseudoaneurysm following orthotopic liver transplantation: long-term results; citation_author=E Volpin, P Pessaux, A Sauvanet, A Sibert, R Kianmanesh, F Durand; citation_volume=19; citation_publication_date=2014; citation_pages=346-352; citation_doi=10.12659/AOT.890473; citation_id=CR4 citation_journal_title=Transplant Proc; citation_title=Pseudoaneurysm of the hepatic artery following liver transplantation; citation_author=J Fistouris, G Herlenius, L Bäckman, M Olausson, M Rizell, L Mjörnstedt; citation_volume=38; citation_publication_date=2006; citation_pages=2679-2682; citation_doi=10.1016/j.transproceed.2006.07.028; citation_id=CR5 citation_journal_title=Ann Vasc Surg; citation_title=Reversed saphenous bypass for hepatic artery pseudoaneurysm after liver transplantation; citation_author=F Panaro, M Miggino, H Bouyabrine, JP Carabalona, JP Berthet, L Canaud; citation_volume=27; citation_publication_date=2013; citation_pages=1088-1097; citation_doi=10.1016/j.avsg.2013.01.007; citation_id=CR6 citation_journal_title=Transpl Int; citation_title=Rescue for rare complications of the hepatic artery in living donor liver transplantation using grafts of autologous inferior mesenteric artery; citation_author=K Asonuma, H Ohshiro, T Izaki, H Okajima, M Ueno, A Kodera; citation_volume=17; citation_publication_date=2004; citation_pages=639-642; citation_doi=10.1111/j.1432-2277.2004.tb00399.x; citation_id=CR7 citation_journal_title=Ann Hepatobiliary Pancreat Surg; citation_title=Application of resuscitative endovascular balloon occlusion in post-transplant mycotic hepatic artery pseudoaneurysm rupture in the setting of Aspergillus Constellatus bacteremia; citation_author=K Stephenson, K Kalkwarf, E Giorgakis; citation_volume=25; citation_publication_date=2021; citation_pages=126-131; citation_doi=10.14701/ahbps.2021.25.1.126; citation_id=CR8 citation_journal_title=Asian J Surg; citation_title=Endovascular treatment for pseudoaneurysms arising from the hepatic artery after liver transplantation; citation_author=A Thorat, CF Lee, TH Wu, KT Pan, SY Chu, HS Chou; citation_volume=40; citation_publication_date=2017; citation_pages=227-231; citation_doi=10.1016/j.asjsur.2014.07.001; citation_id=CR9 citation_journal_title=CVIR Endovasc; citation_title=Arterio-biliary fistula caused by a hepatic artery pseudoaneurysm in a recently performed liver transplant: successful resolution and long-term liver implant preservation using a covered coronary stent; citation_author=A Páez-Carpio, E Serrano, F Zarco, C Fondevila, M Burrel; citation_volume=3; citation_publication_date=2020; citation_pages=93; citation_doi=10.1186/s42155-020-00191-6; citation_id=CR10 citation_journal_title=World J Hepatol; citation_title=Vascular complications following liver transplantation: a literature review of advances in 2015; citation_author=T Piardi, M Lhuaire, O Bruno, R Memeo, P Pessaux, R Kianmanesh; citation_volume=8; citation_publication_date=2016; citation_pages=36-57; citation_doi=10.4254/wjh.v8.i1.36; citation_id=CR11 citation_journal_title=Transplant Proc; citation_title=Diagnosis and management of hepatic artery complications after liver transplantation; citation_author=F Frongillo, MC Lirosi, E Nure, R Inchingolo, G Bianco, N Silvestrini; citation_volume=47; citation_publication_date=2015; citation_pages=2150-2155; citation_doi=10.1016/j.transproceed.2014.11.068; citation_id=CR12 citation_journal_title=Am J Transplant; citation_title=Hepatic artery ligation for arterial rupture following liver transplantation: a reasonable option; citation_author=E Boleslawski, AF Bouras, S Truant, G Liddo, A Herrero, B Badic; citation_volume=13; citation_publication_date=2013; citation_pages=1055-1062; citation_doi=10.1111/ajt.12135; citation_id=CR13 citation_journal_title=Surg Case Rep; citation_title=Massive duodenal ulcer bleeding due to the ruptured hepatic artery pseudoaneurysm after living donor liver transplantation; citation_author=M Kadohisa, Y Inomata, M Sakisaka, Y Sugawara, T Hibi; citation_volume=8; citation_publication_date=2022; citation_pages=199; citation_doi=10.1186/s40792-022-01558-8; citation_id=CR14 citation_journal_title=Transpl Int; citation_title=Hepatic arterial embolization for massive bleeding from an intrahepatic artery pseudoaneurysm using N-butyl-2-cyanoacrylate after living donor liver transplantation; citation_author=HY Ou, AM Concejero, CY Yu, TL Huang, TY Chen, LL Tsang; citation_volume=24; citation_publication_date=2011; citation_pages=e19-22; citation_doi=10.1111/j.1432-2277.2010.01186.x; citation_id=CR15 citation_journal_title=Pol J Radiol; citation_title=Embolization of a true giant splenic artery aneurysm using NBCA glue—case report and literature review; citation_author=M Guziński, J Kurcz, M Kukulska, M Neska, J Garcarek; citation_volume=80; citation_publication_date=2015; citation_pages=155-158; citation_doi=10.12659/PJR.891405; citation_id=CR16 citation_journal_title=Intern Med; citation_title=A successful case of transcatheter arterial embolization with n-butyl-2-cyanoacrylate for pancreatic arteriovenous malformation; citation_author=T Tatsuta, T Endo, K Watanabe, K Hasui, N Sawada, G Igarashi; citation_volume=53; citation_publication_date=2014; citation_pages=2683-2687; citation_doi=10.2169/internalmedicine.53.3327; citation_id=CR17 citation_journal_title=Cardiovasc Intervent Radiol; citation_title=Recanalization of splenic artery aneurysm after transcatheter arterial embolization using N-butyl cyanoacrylate; citation_author=K Matsumoto, Y Ushijima, T Tajima, A Nishie, M Hirakawa, K Ishigami; citation_volume=33; citation_publication_date=2010; citation_pages=187-190; citation_doi=10.1007/s00270-009-9627-2; citation_id=CR18 citation_journal_title=AJR Am J Roentgenol; citation_title=Collateral transformation of the hepatic artery after liver transplantation; citation_author=PB Dydynski, EI Bluth, W Altmeyer, DA Devun, JM Milburn; citation_volume=191; citation_publication_date=2008; citation_pages=546-549; citation_doi=10.2214/AJR.07.3625; citation_id=CR19 citation_journal_title=Transpl Int; citation_title=Liver transplantation and spontaneous neovascularization after arterial thrombosis: “the neovascularized liver”; citation_author=F Panaro, B Gallix, H Bouyabrine, J Ramos, P Addeo, G Testa; citation_volume=24; citation_publication_date=2011; citation_pages=949-957; citation_doi=10.1111/j.1432-2277.2011.01293.x; citation_id=CR20 citation_journal_title=Transplant Proc; citation_title=Hepatic artery thrombosis after orthotopic liver transplantation: 3 patients with collateral formation and conservative treatment; citation_author=I Fouzas, A Sklavos, K Bismpa, I Paxiadakis, N Antoniadis, D Giakoustidis; citation_volume=44; citation_publication_date=2012; citation_pages=2741-2744; citation_doi=10.1016/j.transproceed.2012.09.002; citation_id=CR21 citation_journal_title=Transplant Proc; citation_title=Unconventional extrahepatic neovascularization after transplant hepatic artery thrombosis: a case report; citation_author=L Casadaban, A Parvinian, IG Tzvetanov, H Jeon, J Oberholzer, E Benedetti; citation_volume=45; citation_publication_date=2013; citation_pages=2841-2844; citation_doi=10.1016/j.transproceed.2013.03.048; citation_id=CR22
Thông tin
Thông tin xuất bản

Springer Science and Business Media LLC

Tập 9 Số 1

1-8

Thông tin tác giả