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Title: Endovascular treatment of a hepatic artery pseudoaneurysm using a novel pericardium covered stent.
Austin Authors: Larner, Brett ;Maingard, Julian;Ren, Yifan;Kok, Hong Kuan;Chandra, Ronil V;Lee, Michael J;Schelleman, Anthony ;Brooks, Duncan Mark ;Asadi, Hamed 
Affiliation: Austin Health, Heidelberg, Victoria, Australia
Interventional Radiology Service - Department of Radiology, Northern Hospital, Melbourne, Victoria, Australia
Interventional Neuroradiology Unit, Monash Imaging, Melbourne, Victoria, Australia
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia
Interventional Radiology Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
Interventional Radiology Service - Department of Radiology, Beaumont Hospital, Dublin, Ireland
Royal College of Surgeons in Ireland, Dublin, Ireland..
Interventional Neuroradiology Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
School of Medicine - Faculty of Health, Deakin University, Waurn Ponds, Victoria, Australia
Issue Date: Dec-2019 2019-10-13
Publication information: Journal of Medical Imaging and Radiation Oncology 2019; 63(6): 765-769
Abstract: Visceral and renal artery aneurysms (VRAAs) and pseudoaneurysms are rare. Their increasing incidence is largely thought to be due to advances in medical imaging. Twenty percent of VRAAs occur in hepatic arteries, with approximately fifty percent of these represented by pseudoaneurysms, which are prone to spontaneous rupture. Many treatments for VRAAs exist, with the endovascular approach being favoured. Treatment aims to preserve visceral perfusion and exclude the aneurysm; however, complex aneurysms may require parent artery or end-organ sacrifice. Covered stents allow rapid aneurysm exclusion while preserving parent artery patency, a favourable outcome when parent artery or end-organ sacrifice is undesirable. The AneuGraft pericardium covered stent (PCS) combines the benefits of a low-profile covered stent with those of a low immunogenic material. We describe the endovascular treatment of a patient with a hepatic artery pseudoaneurysm, where parent artery sacrifice was considered unacceptable. The AneuGraft PCS was used to provide immediate and complete exclusion, with dual antiplatelet therapy for 1¬†week, followed by single antiplatelet use. The procedure was a technical success, with preservation of the hepatic arteries and complete exclusion of the pseudoaneurysm. There were no complications immediately following the procedure or on post-procedural follow-up. The pseudoaneurysm remained excluded at 6-week CT angiogram (CTA) follow-up. This case describes a safe and effective method for completely excluding a complex pseudoaneurysm, utilising the AneuGraft PCS, allowing for the potential management of a wider range of aneurysms with unfavourable morphology.
DOI: 10.1111/1754-9485.12960
ORCID: 0000-0003-4279-7401
PubMed URL: 31608606
Type: Journal Article
Subjects: AneuGraft
hepatic artery
pericardium covered stent
visceral artery
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