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| Transcatheter arterial embolization for iatrogenic hepatic artery injury |
| HOU Zhen-guo, ZHANG Liang, GUO Qiang, LU Yan-ping, HE Yu, ZHAO Xin |
| Department of Radiology, the People’s Hospital of Xingtai, Xingtai Hebei 054031, China |
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Abstract Objective: To investigate the performance of digital subtraction angiography(DSA) of iatrogenic hepatic artery injury(IHAI) and the effect of interventional embolization therapy. Methods: Twenty-three cases of IHAI were performed selective artery angioraphy for conforming the location and feature of bleeding. And then super-selective arterial embolization were performed. The embolic agents included coils, microcoils, gelfoam. Result: DSA showed 14 cases of pseudoaneurysm, 5 cases of extravasation, 3 cases of hepatic artery biliary fistula, and 1 case of hepatic artery portal fistula. The success rate of technique was 100%(23/23), and the rate of clinical success was 87.0%(20/23). Two cases were successfully treated by re-embolization, and 1 case was still bleeding after re-embolization. In 1 month after interventional therapy, 3 cases died of septic shock, multiple organ failure and sudden respiratory arrest. Eight cases died of multiple organ failure or malignant tumor after 3~14 months of interventional therapy. The remaining 12 cases were followed up for 1~26 months without any major bleeding. Three days after interventional therapy, the hemoglobin was significantly higher compared with pre-intervention therapy(P<0.05), and the liver function was higher, but there was no significant difference compared with pre-intervention therapy(P>0.05). The hemoglobin and liver function were basically recovered to the normal range in 30 days, and there were no other serious complications. Conclusion: Transcatheter arterial embolization can be the preferred treatment for IHAI.
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Received: 15 October 2018
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2020, Vol. 31 
