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Endovascular treatment of psuedoaneurysm arising from common hepatic artery bifurcation with complete disruption of gastroduodenal artery and high flow arterioportal fistula
Ann Hepatobiliary Pancreat Surg 2019 May;23(2):187-91
Published online May 31, 2019;  https://doi.org/10.14701/ahbps.2019.23.2.187
Copyright © 2019 Korean Association of Hepato-Biliary-Pancreatic Surgery.

Rinoy R Anand, Mathew Cherian P, Pankaj Mehta, Jenny M Gandhi, Elango S, Santosh B Patil

Department of Neuro and Vascular Interventional Radiology, Kovai Medical Center and Hospital Coimbatore, Tamil Nadu, India
Received October 11, 2018; Revised February 1, 2019; Accepted February 7, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Arterio-portal fistulas (APFs) are characterized by anomalous communication between arteries and the portal vein (PV) system. Treatment of APF is imperative as an emergency or if there is development of portal hypertension/heart failure in chronic cases. Both endovascular and surgical managements can be attempted, however since endovascular management carries comparatively low intra and post procedural morbidity it is mostly preferred. This is a case report on endovascular management of post-traumatic pseudoaneurysm arising from bifurcation of common hepatic artery with complete disruption of the gastroduodenal artery and high-flow APF. This report describes the intraprocedure challenges in exclusion of fistula from the circulation, without disruption of portal system and anticipation of recruitment of new collateral feeders to the fistula immediate post exclusion with its embolization, which needs appropriate positioning of the catheter prior to exclusion of the fistula.
Keywords : Psuedoaneurysm; Arterioportal fistula; Endovascular

 

November 2019, 23 (4)