Stent Graft Placement for Postsurgical Hemorrhage from the Hepatic Artery: Clinical Outcome and CT Findings |
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| Affiliation: | 1. Department of Radiology, Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, 135-710, Irwon-Dong, Gangnam Gu, Seoul, Korea;2. 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;1. Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama 641-8510, Japan;2. Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama 641-8510, Japan;1. Division of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114.;2. Division of Molecular Pathology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114.;3. Division of Hematology/Oncology, Center for Liver Cancer, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114.;1. Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642;2. Department of Radiation Oncology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642;1. Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan;2. Department of Gastroenterological Surgery, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan;3. Department of General Thoracic Surgery, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan;1. Department of Radiology, Montefiore Medical Center-Weiler Division, 1825 Eastchester Road, Bronx, NY 10461;2. Department of Radiology, North Shore University Hospital, Manhasset, New York;3. Department of Radiology, New York Medical College, Westmed Medical Group, White Plains, New York;1. Department of Interventional Radiology, St. Antonius Hospital, Koekoekslaan 1, CM Nieuwegein 3435, The Netherlands;2. Department of Vascular Surgery, St. Antonius Hospital, Koekoekslaan 1, CM Nieuwegein 3435, The Netherlands |
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| Abstract: | ![]()
PurposeTo evaluate the clinical results and imaging follow-up findings of stent grafts placed for hemorrhage from hepatic arteries following surgery.Materials and MethodsThe 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.ResultsThere 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).ConclusionsHepatic artery hemorrhage following surgery can be treated effectively with stent graft placement. |
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| Keywords: | DIC" },{" #name" :" keyword" ," $" :{" id" :" key0010" }," $$" :[{" #name" :" text" ," _" :" disseminated intravascular coagulation |
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