PMC8339217_01
Computed tomography scan before intervention. Yellow arrow: dilated common bile duct, red arrow: true aneurysm of the common hepatic artery.
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A computed tomography angiogram (CTA) showed a HAA of the common hepatic artery (CHA) of 53 mm at its bifurcation with the gastroduodenal artery (GDA), compressing and dilating the common bile duct (CBD) (Fig. 1).
Day 1 post-endovascular intervention using a covered stent. Blue arrow: no flow in the hepatic artery aneurysm (HAA); green arrow: stent in HAA; red arrow: common hepatic artery origin.
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A subtraction angiogram showed an excluded HAA with patent flow through the stents and the right hepatic artery (RHA) (Fig. 2).
Day 19 post-endovascular intervention. Blue arrow: flow in hepatic artery aneurysm (HAA); green arrow: stent in HAA; red arrow: common hepatic artery origin dilated.
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The aneurysm itself had grown in diameter with signs of local infection (Fig. 3).
Five days post open repair by ligating the inflow and outflow artery of the hepatic artery aneurysm. Red arrow: common hepatic artery origin ligated.
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The operation was performed successfully by a team of vascular and hepatobiliary surgeons (Fig. 4).