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Stent graft placement and balloon dilation for pseudoaneurysm complicated by distal arterial stenosis of the hepatic artery after pancreaticoduodenectomy

Overview of attention for article published in Surgical Case Reports, July 2015
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Title
Stent graft placement and balloon dilation for pseudoaneurysm complicated by distal arterial stenosis of the hepatic artery after pancreaticoduodenectomy
Published in
Surgical Case Reports, July 2015
DOI 10.1186/s40792-015-0060-2
Pubmed ID
Authors

Shuichi Fujioka, Fumitake Suzuki, Naotake Funamizu, Tomoyoshi Okamoto, Koji Munakata, Hirokazu Ashida, Katsuhiko Yanaga

Abstract

Hemorrhage from ruptured pseudoaneurysm is a rapidly progressing and potentially fatal complication after pancreaticoduodenectomy (PD). Stent graft placement for hepatic artery pseudoaneurysm has recently been reported as a valid alternative to transcatheter arterial embolization (TAE). We report a case of pseudoaneurysm of the common hepatic artery (CHA) with distal arterial stenosis treated by stent graft placement for pseudoaneurysm and balloon dilation for arterial stenosis due to pancreatic fistula after PD. A 67-year-old man underwent PD for intraductal papillary mucinous neoplasm with concomitant early gastric cancer. After the operation, pancreatic fistula developed, for which conservative management by drainage was continued. On the postoperative day 30, melena started. Emergency abdominal angiography revealed a pseudoaneurysm in the CHA, as well as distal arterial stenosis extending from the proper hepatic artery (PHA) to bilateral hepatic arteries. The portal vein was also stenotic due to pancreatic fistula, for which TAE was not judged suitable because of the risk of liver failure. Therefore, stent graft placement and balloon dilation were chosen. Three pieces of coronary covered stent were placed in a coaxial overlapping manner followed by balloon dilation of the proper and left hepatic arteries. Balloon dilation of the right hepatic artery failed by technical reasons. Completion arteriography confirmed the patency from the CHA to the left hepatic artery as well as the exclusion of the pseudoaneurysm. A liver abscess that developed in the right hepatic lobe after intervention was successfully treated by percutaneous drainage, and the patient discharged on day 27 after stent graft placement. Non-embolic management with preservation of the liver arterial flow may be an option for complicated pseudoaneurysm after PD.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 13 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 8%
Unknown 12 92%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 3 23%
Student > Ph. D. Student 2 15%
Student > Postgraduate 2 15%
Student > Doctoral Student 1 8%
Student > Master 1 8%
Other 1 8%
Unknown 3 23%
Readers by discipline Count As %
Medicine and Dentistry 9 69%
Unknown 4 31%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 September 2015.
All research outputs
#22,756,649
of 25,371,288 outputs
Outputs from Surgical Case Reports
#272
of 556 outputs
Outputs of similar age
#235,186
of 275,258 outputs
Outputs of similar age from Surgical Case Reports
#4
of 6 outputs
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