HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026
True hepatic artery aneurysm repair: anatomical complexity and operative adaptability comparing open versus endovascular approach.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Shoucair Sami, Giuseppucci Antonio, Rajesh Vishal, Verma Sapana, Ali Khaled, Wu Wei K, Isaacson Dylan, Rizzo Anthony, Quatromoni Jon G, Lyden Sean P, Caputo Francis J, Fujiki Masato, Hashimoto Koji, Aucejo Federico, Khalil Mazhar
Аннотация
BACKGROUND: Selection of a surgical approach for hepatic artery aneurysms (HAAs) depends on a complex interplay of anatomical, clinical, and technical considerations. This study aimed to evaluate the indications, techniques, and outcomes of endovascular versus open surgical repair in patients with true HAAs.
METHODS: A retrospective review of 33 patients who underwent surgical management for true HAAs (2009-2023). Patients were stratified by treatment modality. Outcomes (procedural success, complications, follow-up) were compared.
RESULTS: Most common aneurysm site was the common hepatic artery (75.7 %), with mean diameter of 3.4 ± 2.6 cm. Seventeen patients (51.5 %) underwent endovascular treatment; sixteen (48.5 %) had primary open repair. Four patients (23.5 %) failed endovascular therapy and required surgical conversion. Patients undergoing open repair had significantly larger aneurysms (4.1 vs. 2.4 cm, p = 0.041) and higher thrombosis rate (60 % vs. 30.8 %, p = 0.049). Reversed saphenous vein grafting was the most common (50 %) reconstructive technique in open surgery. Length of stay (5.8 ± 4.9 vs.8.4 ± 5.1 days), complication rates (15%vs.15.4 %), and follow-up outcomes were comparable between groups.
CONCLUSION: Both endovascular and open approaches offer effective management for true HAAs when selected based on anatomical and clinical factors. Open repair remains essential in complex cases and ensures durable outcomes when endovascular strategies are not feasible or fail.
METHODS: A retrospective review of 33 patients who underwent surgical management for true HAAs (2009-2023). Patients were stratified by treatment modality. Outcomes (procedural success, complications, follow-up) were compared.
RESULTS: Most common aneurysm site was the common hepatic artery (75.7 %), with mean diameter of 3.4 ± 2.6 cm. Seventeen patients (51.5 %) underwent endovascular treatment; sixteen (48.5 %) had primary open repair. Four patients (23.5 %) failed endovascular therapy and required surgical conversion. Patients undergoing open repair had significantly larger aneurysms (4.1 vs. 2.4 cm, p = 0.041) and higher thrombosis rate (60 % vs. 30.8 %, p = 0.049). Reversed saphenous vein grafting was the most common (50 %) reconstructive technique in open surgery. Length of stay (5.8 ± 4.9 vs.8.4 ± 5.1 days), complication rates (15%vs.15.4 %), and follow-up outcomes were comparable between groups.
CONCLUSION: Both endovascular and open approaches offer effective management for true HAAs when selected based on anatomical and clinical factors. Open repair remains essential in complex cases and ensures durable outcomes when endovascular strategies are not feasible or fail.