Placement of a Viabahn stent-graft for hepatic artery pseudoaneurysm complicated by arterial dissection caused by a guiding sheath

Yasuyuki Onishi, MD; Hiroyuki Kimura, MD, PhD; Mitsunori Kanagaki, MD, PhD; Shojiro Oka, MD; Genki Fukumoto, MD; Tomoaki Otani, MD; Naoko Matsubara, MD; Kazuna Kawabata, MD, PhD

Radiology Case Reports (Jun 2019)

Placement of a Viabahn stent-graft for hepatic artery pseudoaneurysm complicated by arterial dissection caused by a guiding sheath

Yasuyuki Onishi, MD,
Hiroyuki Kimura, MD, PhD,
Mitsunori Kanagaki, MD, PhD,
Shojiro Oka, MD,
Genki Fukumoto, MD,
Tomoaki Otani, MD,
Naoko Matsubara, MD,
Kazuna Kawabata, MD, PhD

Affiliations

Yasuyuki Onishi, MD: Corresponding author.; Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
Hiroyuki Kimura, MD, PhD: Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
Mitsunori Kanagaki, MD, PhD: Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
Shojiro Oka, MD: Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
Genki Fukumoto, MD: Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
Tomoaki Otani, MD: Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
Naoko Matsubara, MD: Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
Kazuna Kawabata, MD, PhD: Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan

Journal volume & issue: Vol. 14, no. 6
pp. 711 – 713

Abstract

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A 69-year-old man was transferred to our hospital for massive hemorrhage from a right hepatic artery pseudoaneurysm 5 months after surgery for gastric cancer. Stent-graft placement was planned to avoid fatal hepatic infarction, and a guiding sheath was advanced deeply into the tortuous and stenotic right hepatic artery beyond the pseudoaneurysm for safe deployment of a stent-graft. However, this advancement caused arterial dissection of the right hepatic artery. After the guiding sheath was pulled back, a Viabahn stent-graft was successfully advanced over a guidewire to exclude the pseudoaneurysm. We consider that a Viabahn stent-graft is more flexible than a guiding sheath and that advancing a Viabahn stent-graft directly from a proximally placed guiding sheath is safer than advancing a guiding sheath into a tortuous and stenotic abdominal artery. Keywords: Stent-graft, Pseudoaneurysm, Arterial dissection

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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