Hepatic Infarction following Hepatic Artery Embolization for Iatrogenic Hepatic Arterial Hemorrhage

Hwang, Seong Guen; Kim, Kang Seong; Kim, Kon Hong

Abstract

BACKGROUND
Hepatic artery embolization for the treatment of iatrogenic biliary hemorrhage is a safe and effective alternative to open surgery. However, treatment with hepatic artery embolization can lead to hepatic ischemia or infarction. PURPOSE: To examine the site, frequency and clinical presentation of hepatic ischemia following selective hepatic artery embolization. MATERIAL & METHODS: We reviewed medical records of 11 hepatic ischemia patients on a retrospective basis, who received treatment between January 1997 to March 2009.
RESULTS
Primary disease in 11 cases were early gastric cancer in 3 cases, chronic recurrent pancreatitis in 2 cases, choledochal cyst in 2 cases, chronic calculus cholecystitis in 2 cases, GB cancer in 1 case and recurrent HCC in 1 case. In all cases, embolized material was coil. Five cases (45.5%) resulted in hepatic abscesses and managed with percutaneous drainage, but 4 cases were died.
CONCLUSION
Hepatic artery embolization is an effective method for the treatment of iatrogenic hepatic artery hemorrhage, but it has a high mortality due to liver infarction. For this reason, superselective embolization, or stent insertion, should be considered in high risk patients.