PMC6490088_01
The enhanced CT shows huge aneurysm of common hepatic artery (the white arrow) (A). The enhanced CT shows a diffusive extension of the splenic artery (SA), proper hepatic artery (PHA), gastroduodenal artery (GDA), and string-of-beads appearances of superior mesenteric artery (SMA; the black arrows) (B). The 3D-processed CT examination which accurately details the arteries involved in the process (C). CT, computed tomography.
gr1.jpg
PMC6490088_01_gr1.jpg
fig0001
An abdominal contrast-enhanced CT scan showed that the size of the aneurysm of the CHA was 44 mm and 0.9 mm increase from 2 years ago (Fig. 1A).
A stentgraft (10-mm diameter, 80-mm length, FLUENCY Plus Endovascular Stent Graft; Bard Peripheral Vascular, Tempe, AZ) was placed from the CHA with transition to the PHA; the distal part of the stent hits a wall of the proper hepatic artery (the black arrow), and there are thrombi in a lumen of the stent and in the proper hepatic artery (the white arrows) (A). Additional stentgraft (10-mm diameter, 60-mm length SMART; Cardinal Health, Dublin, OH) was deployed in the lumen of the previous stent and the lumen of the own artery of the liver (B). Control angiography shows filling of the left hepatic artery through the pancreatic arch (C). CHA, common hepatic artery; PHA, proper hepatic artery.
gr2.jpg
PMC6490088_01_gr2.jpg
fig0002
In addition, the CT revealed a diffusive extension of the splenic artery, proper hepatic artery, gastroduodenal artery, and a string-of-beads appearance of the superior mesenteric artery (Fig. 2B and C). Dublin, OH) was deployed in the lumen of the previous stent and the lumen of the own artery of the liver. During the control angiography, the liver was contrasted through the pancreatic arcade to the left hepatic artery (Fig. 2A-C).
(A) The contrast-enhanced CT 10 months after stenting. (B) The contrast-enhanced CT 5 years after intervention. CT, computed tomography.
gr3.jpg
PMC6490088_01_gr3.jpg
fig0003
At the 6-year follow-up (Fig. 3), the patient was well and there were no significant interval changes in other visceral arteries or veins.