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Large Hepatic Artery Pseudoaneurysm Resection After Orthotopic Liver Transplantation
Patient: Female, 41 Final Diagnosis: Hepatiic artery aneurysm Symptoms: None Medication: — Clinical Procedure: — Specialty: Surgery OBJECTIVE: Rare disease BACKGROUND: Hepatic artery (HA) pseudoaneurysm (PSA) after liver transplantation (OLTx) is rare but often fatal complication requiring quick rep...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839540/ https://www.ncbi.nlm.nih.gov/pubmed/31662581 http://dx.doi.org/10.12659/AJCR.917728 |
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author | Novotny, Robert Janousek, Libor Lipar, Kvetoslav Chlupac, Jaroslav Fronek, Jiri |
author_facet | Novotny, Robert Janousek, Libor Lipar, Kvetoslav Chlupac, Jaroslav Fronek, Jiri |
author_sort | Novotny, Robert |
collection | PubMed |
description | Patient: Female, 41 Final Diagnosis: Hepatiic artery aneurysm Symptoms: None Medication: — Clinical Procedure: — Specialty: Surgery OBJECTIVE: Rare disease BACKGROUND: Hepatic artery (HA) pseudoaneurysm (PSA) after liver transplantation (OLTx) is rare but often fatal complication requiring quick repair. Its prevalence in patients after OLTx is around 0.94%. CASE REPORT: A 41-year-old female patient underwent a full-graft orthotopic liver transplantation (OLTx) for alcoholic liver cirrhosis in 2017. During regular postoperative Doppler ultrasonography (DU) check-ups, a large 3-cm pseudo-aneurysm (PSA) was detected on the hepatic artery. The patient underwent a computed angiography (CTA) to verify the PSA anatomical localization and relationship with the transplanted liver graft. Selective celiac arteriography showed HA PSA and 90% stenosis of the hepatic artery after PSA. The stent graft placement was unsuccessful as the guiding wire was unable to pass through the post-PSA HA stenosis. The patient was scheduled for an open repair under general anesthesia. Through a right subcostal incision, the HA PSA was resected and the HA was mobilized and re-anastomosed using an end-to-end technique. Three months after the procedure, the patient has a good liver graft perfusion through the HA with no sign of PSA reoccurrence or stenosis. CONCLUSIONS: Early detection of the HA PSA after OLTx is a life-threatening complication requiring prompt treatment. If endovascular treatment options fail, open surgical repair, despite its challenges, is the only possible treatment option. |
format | Online Article Text |
id | pubmed-6839540 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-68395402019-11-14 Large Hepatic Artery Pseudoaneurysm Resection After Orthotopic Liver Transplantation Novotny, Robert Janousek, Libor Lipar, Kvetoslav Chlupac, Jaroslav Fronek, Jiri Am J Case Rep Articles Patient: Female, 41 Final Diagnosis: Hepatiic artery aneurysm Symptoms: None Medication: — Clinical Procedure: — Specialty: Surgery OBJECTIVE: Rare disease BACKGROUND: Hepatic artery (HA) pseudoaneurysm (PSA) after liver transplantation (OLTx) is rare but often fatal complication requiring quick repair. Its prevalence in patients after OLTx is around 0.94%. CASE REPORT: A 41-year-old female patient underwent a full-graft orthotopic liver transplantation (OLTx) for alcoholic liver cirrhosis in 2017. During regular postoperative Doppler ultrasonography (DU) check-ups, a large 3-cm pseudo-aneurysm (PSA) was detected on the hepatic artery. The patient underwent a computed angiography (CTA) to verify the PSA anatomical localization and relationship with the transplanted liver graft. Selective celiac arteriography showed HA PSA and 90% stenosis of the hepatic artery after PSA. The stent graft placement was unsuccessful as the guiding wire was unable to pass through the post-PSA HA stenosis. The patient was scheduled for an open repair under general anesthesia. Through a right subcostal incision, the HA PSA was resected and the HA was mobilized and re-anastomosed using an end-to-end technique. Three months after the procedure, the patient has a good liver graft perfusion through the HA with no sign of PSA reoccurrence or stenosis. CONCLUSIONS: Early detection of the HA PSA after OLTx is a life-threatening complication requiring prompt treatment. If endovascular treatment options fail, open surgical repair, despite its challenges, is the only possible treatment option. International Scientific Literature, Inc. 2019-10-30 /pmc/articles/PMC6839540/ /pubmed/31662581 http://dx.doi.org/10.12659/AJCR.917728 Text en © Am J Case Rep, 2019 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) ) |
spellingShingle | Articles Novotny, Robert Janousek, Libor Lipar, Kvetoslav Chlupac, Jaroslav Fronek, Jiri Large Hepatic Artery Pseudoaneurysm Resection After Orthotopic Liver Transplantation |
title | Large Hepatic Artery Pseudoaneurysm Resection After Orthotopic Liver Transplantation |
title_full | Large Hepatic Artery Pseudoaneurysm Resection After Orthotopic Liver Transplantation |
title_fullStr | Large Hepatic Artery Pseudoaneurysm Resection After Orthotopic Liver Transplantation |
title_full_unstemmed | Large Hepatic Artery Pseudoaneurysm Resection After Orthotopic Liver Transplantation |
title_short | Large Hepatic Artery Pseudoaneurysm Resection After Orthotopic Liver Transplantation |
title_sort | large hepatic artery pseudoaneurysm resection after orthotopic liver transplantation |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839540/ https://www.ncbi.nlm.nih.gov/pubmed/31662581 http://dx.doi.org/10.12659/AJCR.917728 |
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