PURPOSE: To study the sequelae of iatrogenic dissection of the celiac axis and its branches in a large patient population. METHODS: We analyzed 40 patients with hepatocellular carcinoma (HCC) whose celiac artery or its branches were dissected during transcatheter arterial embolization (TAE) and underwent follow-up angiography within 2 months. RESULTS: The two most common sites of dissection were the celiac artery in 13 patients (32.5%) and the proper hepatic artery in 11 patients (27.5%). Follow-up angiography revealed complete recanalization in 32.5% (13/40), irregularity and narrowing of the lumen in 40% (16/40), and complete obstruction in 27.5% (11/40). Therefore, 72.5% (29/40) of the dissected arteries recanalized. Pseudoaneurysm formation of the dissected artery was observed in 32.5% (13/40). Subsequent TAE was possible via the dissected arteries in 79% (27/34) of patients in this series. CONCLUSION: Iatrogenic dissection of the celiac and proximal hepatic arteries heals spontaneously in the majority of patients, and in most instances allows subsequent TAE.
PURPOSE: To study the sequelae of iatrogenic dissection of the celiac axis and its branches in a large patient population. METHODS: We analyzed 40 patients with hepatocellular carcinoma (HCC) whose celiac artery or its branches were dissected during transcatheter arterial embolization (TAE) and underwent follow-up angiography within 2 months. RESULTS: The two most common sites of dissection were the celiac artery in 13 patients (32.5%) and the proper hepatic artery in 11 patients (27.5%). Follow-up angiography revealed complete recanalization in 32.5% (13/40), irregularity and narrowing of the lumen in 40% (16/40), and complete obstruction in 27.5% (11/40). Therefore, 72.5% (29/40) of the dissected arteries recanalized. Pseudoaneurysm formation of the dissected artery was observed in 32.5% (13/40). Subsequent TAE was possible via the dissected arteries in 79% (27/34) of patients in this series. CONCLUSION: Iatrogenic dissection of the celiac and proximal hepatic arteries heals spontaneously in the majority of patients, and in most instances allows subsequent TAE.
Authors: C R Rees; J C Palmaz; G J Becker; K O Ehrman; G M Richter; G Noeldge; B T Katzen; M D Dake; D E Schwarten Journal: Radiology Date: 1991-11 Impact factor: 11.105