What are the causes and treatments for hepatic artery aneurysms?

What are the causes of hepatic artery aneurysm? What are the treatments?

1 Trauma 35%:

Common causes include trauma, bile duct infection, polyarteritis nodosa, arteriosclerosis, cholelithiasis eroding the arterial wall, etc. Those caused by trauma and infection are mostly pseudoaneurysms; vascular wall degeneration or congenital developmental defects may also be the cause of the disease.

2 Pathogenesis:

Hepatic artery aneurysms are usually cystic, with diameters ranging from 2 to 10 cm. Most hepatic artery aneurysms are located outside the liver. True intrahepatic aneurysms are relatively rare, and false aneurysms caused by bacterial infection are common. Hepatic artery aneurysms compress the common bile duct, hepatic duct and cystic duct, which can cause biliary necrosis of intrahepatic bile ductules, extrahepatic bile duct obstruction, hepatic infarction, etc. The wall of the bile duct mostly shows nonspecific inflammatory changes. 25% have arteriosclerosis or calcification, and granulation tissue, thrombosis and bleeding may also be seen.

What are the treatments?

1. The mortality rate after rupture of hepatic artery aneurysm can be as high as 40% to 100%. Therefore, once hepatic artery aneurysm is diagnosed, it should be treated surgically or by interventional means. Since hepatic artery ligation generally does not cause serious liver blood supply obstruction, it is possible to try to block the hepatic artery first and observe the blood supply of the liver. If there is no blood supply obstruction, the tumor can be ligated or ligated and resected. If there is a blood supply obstruction, it needs to be resected and then bypassed with autologous vein or artificial blood vessel bypass. For hepatic artery aneurysms of intrahepatic arterial branches, partial liver resection of the corresponding liver segment can be performed.

2. In recent years, with the improvement of interventional equipment and technology, for those aneurysms at the distal end of the hepatic artery, especially those close to the second and third hepatic hilum, which have a dangerous anatomical location and great risk of surgical operation, superselective vascular embolization can be used to treat hepatic artery aneurysms and hepatic artery aneurysm rupture, including the release of micro-rings, detachable balloons, spring coils, embolic glue, etc., with a success rate of up to 76%.