膵頭十二指腸切除後の仮性動脈瘤出血に対し冠動脈用カバードステントで止血し得た1例

概要

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Arterial hemorrhage after pancreatoduodenectomy is a life-threatening complication associated with a high mortality rate. Even when successfully treated with transarterial embolization, liver infarction, liver abscess or liver failure sometimes occurs after common/proper hepatic artery embolization. Decrease of potential collateral routes for hepatic artery due to surgical ligature or lymphadenectomy increases the risk of ischemia of the liver and biliary system. We report a 50's-year-old male successfully treated with coronary covered stent to preserve hepatic arterial flow. A 3×16-mm balloon-expandable coronary covered stent was placed in the common hepatic artery to cover a pseudoaneurysm of a gastroduodenal artery stump. Postdilatation was performed using a 4×15-mm PTA balloon catheter. No recurrent bleeding or liver functional damage was observed after the procedure. Patency of the stent was confirmed during 2-year follow-up. Covered stent placement was considered to be a useful option for hemorrhage from the proximal side of the hepatic artery, especially in high-risk cases of liver infarction.
一般社団法人日本インターベンショナルラジオロジー学会の論文