Hepatic artery aneurysm: Factors that predict complications

Maher A. Abbas, Richard J. Fowl, William M. Stone, Jean M. Panneton, W. Andrew Oldenburg, Thomas C. Bower, Kenneth J. Cherry, Peter Gloviczki

Research output: Contribution to journalArticlepeer-review

198 Scopus citations

Abstract

Objective: We reviewed the Mayo Clinic experience with management and outcome of hepatic artery aneurysms (HAA). Methods: Retrospective review of charts for 306 patients with true visceral aneurysm diagnosed from 1980 to 1998 enabled identification of 36 patients (12%) with HAA. Results: Patients with HAA included 23 men and 13 women, with mean age of 62.2 years (range, 20-85 years). Most aneurysms were extrahepatic (78%) and single (92%). Mean aneurysm diameter at presentation was 3.6 cm (range, 1.5-14 cm). Five aneurysms had ruptured (14%), and four were symptomatic (11%). Mortality from rupture was 40%. Of the 9 patients with ruptured or symptomatic aneurysms, 2 patients had multiple HAA, 3 patients had fibromuscular dysplasia, and 2 patients had polyarteritis nodosa. All five HAAs that ruptured were of nonatherosclerotic origin (P = .001). Fourteen patients (39%) underwent elective procedures, including excision with vein graft (n = 7), excision with dacron graft (n = 3), excision alone (n = 2), and percutaneous embolization (n = 2). Two vein grafts and one dacron graft became occluded within 1 year. Nonoperative management was elected in 22 patients (61%) with mean aneurysm diameter 2.3 cm (range, 1.5-5 cm). No complications related to the aneurysm occurred during mean follow-up of 68.4 months (range, 1-372 months). Aneurysm growth was identified in 27%, the greatest being 0.8 cm over 34 months. Conclusions: HAA are at definite risk for rupture (14%). Risk factors for rupture include multiple HAA and nonatherosclerotic origin. Patients with symptomatic aneurysms or any of these risk factors should be considered for intervention.

Original languageEnglish (US)
Pages (from-to)41-45
Number of pages5
JournalJournal of vascular surgery
Volume38
Issue number1
DOIs
StatePublished - Jul 2003

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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