Stent-graft treatment of patients with acute bleeding from hepatic artery branches

Purpose: To present a new treatment option in patients with acute bleeding from the hepatic artery branches. Methods: Four male patients, 23-49 years old (mean 36.3 years), were treated for acute bleeding and subsequent transient hypotension. Bleeding episodes were secondary to hepatic artery pseudoaneurysms in two patients and surgical suture insufficiency in one patient. In the remaining patient, anastomotic leakage occurred following thrombolysis for hepatic artery thrombosis. Patients were treated by endovascular placement of one or two balloon-expandable stent-grafts, ranging from 17 to 28 mm in length. Results: All procedures were carried out without serious complications. All stent-grafts were deployed in the intended position with immediate cessation of bleeding and initial preservation of satisfactory blood flow. Conclusions: Bleeding from the hepatic artery can be treated by insertion of balloon-expandable stent-grafts in the acute setting.