Management of Pancreaticoduodenal Artery Aneurysms Based on a Single-Institution Experience

2021 ◽  
pp. 153857442110171
Author(s):  
Kunal Vani ◽  
Keith D. Calligaro ◽  
Krystal Maloni ◽  
Nicholas Madden ◽  
Douglas A. Troutman ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Endovascular Therapy ◽  
Mesenteric Artery ◽  
Celiac Artery ◽  
Surgical Reconstruction ◽  
Single Center ◽  
Single Institution ◽  
Pancreaticoduodenal Artery ◽  
Single Center Experience ◽  
High Propensity

Objectives: Pancreaticoduodenal artery aneurysms (PDAAs) are rare and have a high propensity for rupture. Historically, management of PDAAs included surgical reconstruction but has evolved with advances in endovascular therapy. We report our experience with management of PDAAs during the last 30 years. Methods: We retrospectively reviewed our prospectively maintained registry between January 1, 1992 – March 30, 2020. Results: We identified 8 patients with PDAAs: 4 with associated celiac artery occlusive disease and 4 without identifiable etiologies. Four patients were treated with surgical resection of the PDAAs: 2 intact aneurysms underwent concomitant revascularization (superior mesenteric artery-to-hepatic artery Dacron bypass; supra celiac aorta-to-hepatic artery Dacron bypass) and 2 (1 intact, 1 rupture) underwent ligation alone. Four patients were treated with coil embolization of the PDAA: 2 with concomitant stent-graft exclusion of the aneurysm (1 non-rupture, 1 rupture) and 2 without adjunctive measures (intact). There were no deaths nor any significant procedure-related morbidity. Conclusion: Our large single-center experience shows that PDAAs can be successfully treated by open or endovascular intervention with selective revascularization.

scholarly journals Reconstruction of Aberrant Left Hepatic Artery in Orthotopic Liver Transplantation – Single Center Experience

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Plamen Mihaylov ◽  
◽  
Burcin Ekser ◽  
Daiki Soma ◽  
Andrew Lutz ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatic Artery ◽  
Graft Survival ◽  
Arterial System ◽  
Single Center ◽  
Left Hepatic Artery ◽  
Entire Cohort ◽  
Single Center Experience ◽  
Aberrant Left Hepatic Artery ◽  
Low Incidence

One of the most feared complications in liver transplantation is hepatic arterial thrombosis (HAT). The incidence of HAT in liver transplantation varies from 1.2% and 8%. One of the risk factors for this complication is anatomical complexity of hepatic arterial system. The focus of this short communication is to show our approach in dealing with aberrant left hepatic artery in settings of liver transplantation. This is a single center experience. Between January 2016 and June 2019, we procured and transplanted 357 adult liver allografts. Of these, there were 34 (9.5%) livers with aberrant left hepatic artery. All of them have been reconstructed on bench table. There was no incidence of HAT in the entire cohort with ALHA. The one-year graft survival for this patient cohort was 93.1%. Our surgical approach resulted in a low incidence of HAT of 1% with excellent graft survival.

A single center experience with heart retransplantation: the 29 year experience at a single institution

2007 ◽  
pp. 229-236
Author(s):  
Sharon A. Hunt ◽  
Robert C. Robbins ◽  
Edward B. Stinson ◽  
Phillip E. Dyer ◽  
Norman E. Shumway ◽  
...  
Keyword(s):  
Single Center ◽  
Single Institution ◽  
Single Center Experience

Chemoembolization for Hepatocellular Carcinoma via the Inferior Pancreaticoduodenal Artery in Patients with Celiac Artery Stenosis

1993 ◽  
Vol 34 (1) ◽  
pp. 20-25 ◽  
Author(s):  
M. Okazaki ◽  
H. Higashihara ◽  
H. Ono ◽  
F. Koganemaru ◽  
R. Fujimitsu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Artery ◽  
Fluid Collection ◽  
Survival Rates ◽  
Celiac Artery ◽  
Artery Stenosis ◽  
Proper Hepatic Artery ◽  
Pancreaticoduodenal Artery ◽  
Group A ◽  
Group B

Twenty-one patients with hepatocellular carcinoma (HCC) accompanied by extensive celiac artery stenosis or obstruction were treated by chemoembolization via the inferior pancreaticoduodenal artery (IPDA). The tip of the catheter was placed in the arteries in front of the confluence with the proper hepatic artery in 12 patients (group A: the proximal portion of the IPDA in 10, and common hepatic artery in 2), and in the proper hepatic artery or branches of it (group B) in 9 using a coaxial catheter system. Transient hyperamylasemia was observed in 10 of the 12 patients in group A and in 3 of the 9 patients in group B after chemoembolization. Splenic infarction developed in 8 patients in group A and in none in group B. Intrapancreatic fluid collection was present in 2 patients in group A following chemoembolization. No fatal complications were encountered. The 1-, 2-, and 3-year survival rates of the 10 patients in group A treated by only chemoembolization were 90, 57, and 23%, respectively (mean survival 780 days). The 1- and 2-year survival rates of 9 patients in group B were 85.8 and 85.8% (mean 879 days), respectively. Considering the severity of complications and the survival rates in groups A and B, chemoembolization by superselective catheterization into the hepatic artery via the IPDA is the treatment of choice. However, chemoembolization from the arteries in front of the confluence with the proper hepatic artery seems to be acceptable in cases of hypervascular HCC which fail to be superselectively catheterized.

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