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Pancreaticoduodenal arcades as salvage route for transarterial embolization of life-threatening hepatic hemorrhage in patients with severe celiac axis stenosis: Case series
INTRODUCTION: Various transarterial embolotherapies for different hepatic etiologies are performed through the celiac axis (CA). However, this pathway is not always patent due to the extensive stenosis or occlusion of the origin of CA. In such situations, the pancreaticoduodenal arcades (PDAs) cathe...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066468/ https://www.ncbi.nlm.nih.gov/pubmed/29763851 http://dx.doi.org/10.1016/j.ijscr.2018.03.043 |
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author | Barah, Ali Omar, Ahmed El-Menyar, Ayman Almokdad, Omran Sayedin, Ahmed Alsherbini, Ala Almuzrakshi, Ahmed Khalaf, Hatem Al-Thani, Hassan |
author_facet | Barah, Ali Omar, Ahmed El-Menyar, Ayman Almokdad, Omran Sayedin, Ahmed Alsherbini, Ala Almuzrakshi, Ahmed Khalaf, Hatem Al-Thani, Hassan |
author_sort | Barah, Ali |
collection | PubMed |
description | INTRODUCTION: Various transarterial embolotherapies for different hepatic etiologies are performed through the celiac axis (CA). However, this pathway is not always patent due to the extensive stenosis or occlusion of the origin of CA. In such situations, the pancreaticoduodenal arcades (PDAs) catheterization is the main alternative to gain access to the hepatic arteries as demonstrated in clinical studies. PRESENTATION OF CASE: We report two cases of life-threating hepatic hemorrhage indicated for emergency transarterial embolization (TAE). DISCUSSION: The massive hemorrhage was due to spontaneous rupture of hepatocellular carcinoma (HCC) in the first case and due to post liver blunt trauma in the second case. Owing to severe stenosis of the origin of CA, PDAs were used as a salvage alternative route for emergency TAE of hepatic arteries. CONCLUSION: Endovascular management of massive hepatic hemorrhage in cases of inaccessibility to hepatic arteries through CA is a highly challenging situation in which the technical success depends on the operator experience, choice of the material and anatomical knowledge of hepatic arterial collateral supply. |
format | Online Article Text |
id | pubmed-6066468 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-60664682018-08-01 Pancreaticoduodenal arcades as salvage route for transarterial embolization of life-threatening hepatic hemorrhage in patients with severe celiac axis stenosis: Case series Barah, Ali Omar, Ahmed El-Menyar, Ayman Almokdad, Omran Sayedin, Ahmed Alsherbini, Ala Almuzrakshi, Ahmed Khalaf, Hatem Al-Thani, Hassan Int J Surg Case Rep Article INTRODUCTION: Various transarterial embolotherapies for different hepatic etiologies are performed through the celiac axis (CA). However, this pathway is not always patent due to the extensive stenosis or occlusion of the origin of CA. In such situations, the pancreaticoduodenal arcades (PDAs) catheterization is the main alternative to gain access to the hepatic arteries as demonstrated in clinical studies. PRESENTATION OF CASE: We report two cases of life-threating hepatic hemorrhage indicated for emergency transarterial embolization (TAE). DISCUSSION: The massive hemorrhage was due to spontaneous rupture of hepatocellular carcinoma (HCC) in the first case and due to post liver blunt trauma in the second case. Owing to severe stenosis of the origin of CA, PDAs were used as a salvage alternative route for emergency TAE of hepatic arteries. CONCLUSION: Endovascular management of massive hepatic hemorrhage in cases of inaccessibility to hepatic arteries through CA is a highly challenging situation in which the technical success depends on the operator experience, choice of the material and anatomical knowledge of hepatic arterial collateral supply. Elsevier 2018-04-11 /pmc/articles/PMC6066468/ /pubmed/29763851 http://dx.doi.org/10.1016/j.ijscr.2018.03.043 Text en © 2018 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Barah, Ali Omar, Ahmed El-Menyar, Ayman Almokdad, Omran Sayedin, Ahmed Alsherbini, Ala Almuzrakshi, Ahmed Khalaf, Hatem Al-Thani, Hassan Pancreaticoduodenal arcades as salvage route for transarterial embolization of life-threatening hepatic hemorrhage in patients with severe celiac axis stenosis: Case series |
title | Pancreaticoduodenal arcades as salvage route for transarterial embolization of life-threatening hepatic hemorrhage in patients with severe celiac axis stenosis: Case series |
title_full | Pancreaticoduodenal arcades as salvage route for transarterial embolization of life-threatening hepatic hemorrhage in patients with severe celiac axis stenosis: Case series |
title_fullStr | Pancreaticoduodenal arcades as salvage route for transarterial embolization of life-threatening hepatic hemorrhage in patients with severe celiac axis stenosis: Case series |
title_full_unstemmed | Pancreaticoduodenal arcades as salvage route for transarterial embolization of life-threatening hepatic hemorrhage in patients with severe celiac axis stenosis: Case series |
title_short | Pancreaticoduodenal arcades as salvage route for transarterial embolization of life-threatening hepatic hemorrhage in patients with severe celiac axis stenosis: Case series |
title_sort | pancreaticoduodenal arcades as salvage route for transarterial embolization of life-threatening hepatic hemorrhage in patients with severe celiac axis stenosis: case series |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066468/ https://www.ncbi.nlm.nih.gov/pubmed/29763851 http://dx.doi.org/10.1016/j.ijscr.2018.03.043 |
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