F Pilleul1, P J Valette. 1. Pavilion H sous-sol Radiologie, Service du Pr P.J. Valette, Hôpital Edouard Herriot, place d'Arsonval, F69003 Lyon. frank.pilleul@chu-lyon.fr
Abstract
OBJECTIVES: There appears to be an increasing number of patients with aneurysm of the hepatic artery. We report a retrospective analysis of management schemes used in a single hospital unit over the last 14 years. PATIENTS AND METHODS: Clinical data on all patients with aneurysm of the hepatic artery, treated in Edouard-Herriot hospital (Lyon, France) from 1985 to 1999, were reviewed. RESULTS: There were 15 patients with 16 aneurysms. Mean patient age was 56 years with no gender predominance. The aneurysm was a fortuitous discovery in 8 of the patients. There were 10 cases of pseudoaneurysm and 6 cases of true aneurysm. Treatment was adapted to the local anatomy and the patient's status. Surgery was used for 5 patients and radiologic embolization for 4. Observation was indicated in 5 patients and spontaneous thrombosis occurred in 1. Mean duration of observation was 24 months. Six patients were lost to follow-up and 2 died from their primary disease. DISCUSSION: Surgery is the treatment of choice for aneurysms situated in an extrahepatic localization while radiologic embolization is appropriate for intrahepatic localizations. Close cooperation between the surgery and radiology teams was most contributive to proper management in our series, providing favorable outcome.
OBJECTIVES: There appears to be an increasing number of patients with aneurysm of the hepatic artery. We report a retrospective analysis of management schemes used in a single hospital unit over the last 14 years. PATIENTS AND METHODS: Clinical data on all patients with aneurysm of the hepatic artery, treated in Edouard-Herriot hospital (Lyon, France) from 1985 to 1999, were reviewed. RESULTS: There were 15 patients with 16 aneurysms. Mean patient age was 56 years with no gender predominance. The aneurysm was a fortuitous discovery in 8 of the patients. There were 10 cases of pseudoaneurysm and 6 cases of true aneurysm. Treatment was adapted to the local anatomy and the patient's status. Surgery was used for 5 patients and radiologic embolization for 4. Observation was indicated in 5 patients and spontaneous thrombosis occurred in 1. Mean duration of observation was 24 months. Six patients were lost to follow-up and 2 died from their primary disease. DISCUSSION: Surgery is the treatment of choice for aneurysms situated in an extrahepatic localization while radiologic embolization is appropriate for intrahepatic localizations. Close cooperation between the surgery and radiology teams was most contributive to proper management in our series, providing favorable outcome.