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Coil embolization of a thoracic aorta hematoma with branch artery pseudoaneurysm - case report.

ABSTRACT: BACKGROUND:A thoracic aorta hematoma with branch artery pseudonaneurysm is a very rare complication of thoraric blunt trauma. The standard treatment of this type of injury is aortic endograft placement. CASE PRESENTATION:We present a case in which a thoracic aorta hematoma with branch artery pseudoaneurysm was treated with coil embolization instead of endografting. CONCLUSIONS:Coil embolization of aortic injuries may be a safe and definitive treatment alternative in selected cases. This technique has the potential to reduce the risk of procedure-related complications.

SUBMITTER: Szabo L

PROVIDER: S-EPMC7429636 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Coil embolization of a thoracic aorta hematoma with branch artery pseudoaneurysm - case report.

Szabo Lorant L Reyes Del Castillo Tomas T Benz David D Roos J J Seelos Robert R Lopez-Benitez Ruben R

CVIR endovascular 20200816 1

<h4>Background</h4>A thoracic aorta hematoma with branch artery pseudonaneurysm is a very rare complication of thoraric blunt trauma. The standard treatment of this type of injury is aortic endograft placement.<h4>Case presentation</h4>We present a case in which a thoracic aorta hematoma with branch artery pseudoaneurysm was treated with coil embolization instead of endografting.<h4>Conclusions</h4>Coil embolization of aortic injuries may be a safe and definitive treatment alternative in selecte ...[more]

PMID: 32803509

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Project description:BackgroundAfter orthotopic liver transplantation (OLT), complications such as hepatic artery stenosis, thrombosis, and bleeding are possible. Hepatic artery pseudoaneurysms (HAP) are prone to rupture, rupture hemorrhage, and increased mortality risk. Endovascular treatment of HAP may result in recurrence, even after successful embolization with thrombin. Formation of a HAP in the common hepatic artery (CHA) is challenging because the CHA is the only artery in the liver graft after OLT. Therefore, CHA embolization in HAP is not an initial option. We report a case of HAP at the CHA after OLT that was treated with endovascular therapy, resulting in the occlusion of the CHA with coil embolization, achieving a radical cure.Case presentationA 59-year-old man with decompensated hepatitis C virus cirrhosis underwent deceased donor whole-liver transplantation after graft failure of a living donor liver transplantation. After the second transplantation, the patient developed infectious narrow-necked HAP at the CHA associated with postoperative pancreatic fistula. Repeated transcatheter arterial embolization with thrombin and n-butyl-2-cyanoacrylate was unsuccessful, as confirmed by postprocedure angiography, which revealed recanalization and regrowth of the HAP. Eight months after the first transcatheter arterial embolization, the patient presented with a chief complaint of abdominal pain due to an enlarged HAP. Angiography of the superior mesenteric artery (SMA) revealed a collateral bypass around the bile duct from the SMA to the liver graft. Coil embolization of the HAP in the CHA completely occluded the HAP without complications. More than 2 years after coil embolization, the liver graft function test results remained within normal limits without HAP recurrence.ConclusionsHAP at the CHA after liver transplantation can be fatal if ruptured. Because the liver is a highly angiogenic organ, even if initial treatment is not successful, radical treatment to occlude the CHA with HAP is possible if sufficient collateral vessels are developed.

Dataset Information

Coil embolization of a thoracic aorta hematoma with branch artery pseudoaneurysm - case report.

Publications

Coil embolization of a thoracic aorta hematoma with branch artery pseudoaneurysm - case report.

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