Value of hepatic arteriography combined with embolization in the diagnosis and treatment of hepatic artery pseudoaneurysm

Objective: To investigate the clinical value of hepatic arteriography combined with embolization in the diagnosis and treatment of hepatic artery pseudoaneurysm (HAPA). Methods: The clinical and imaging data of 19 patients with HAPA admitted to our hospital from January 2009 to March 2017 were retrospectively analyzed. HAPA developed after surgery for abdominal tumors (12) or cholangiolithiasis (3), trauma (2), hepatic arterial chemoembolization (1), and renal transplantation (1). All 19 patients underwent selective hepatic arteriography. Results: 9 patients with intrahepatic pseudoaneurysms were treated with gelatin sponge combined with coil embolization (7), coil embolization (1), and polyvinyl alcohol particle embolization (1). 10 patients with extrahepatic pseudoaneurysms were treated with coil embolization (8) or gelatin sponge combined with coil embolization (1) whereas 1 patient underwent conservative treatment due to spasm and dissection of the parent artery. During the postoperative follow-up, 1 patient underwent further interventional embolization because of recurrent pseudoaneurysm secondary to coil shift on postoperative day 21, 4 patients were lost to follow up, and the other 13 patients did not present any postoperative complications related to interventional embolization. Conclusion: Selective hepatic arteriography combined with transcatheter arterial embolization is effective and safe for diagnosing and treating HAPA. (authors)