Long-term clinical outcomes after endovascular management of ruptured pseudoaneurysm in patients undergoing pancreaticoduodenectomy
10.4174/astr.2019.96.5.237
- Author:
Yunghun YOU
1
;
Seong Ho CHOI
;
Dong Wook CHOI
;
Jin Seok HEO
;
In Woong HAN
;
Sunjong HAN
;
Sung Wook SHIN
;
Kwang Bo PARK
;
Hong Suk PARK
;
Sung Ki CHO
;
Sang Hyup HAN
Author Information
1. Department of Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea.
- Publication Type:Original Article
- Keywords:
Stents;
Therapeutic embolization;
Pseudoaneurysm;
Pancreaticoduodenectomy
- MeSH:
Aneurysm, False;
Blood Vessel Prosthesis;
Embolization, Therapeutic;
Follow-Up Studies;
Hemostasis;
Humans;
Medical Records;
Mortality;
Pancreaticoduodenectomy;
Retrospective Studies;
Rupture;
Stents;
Thrombosis
- From:Annals of Surgical Treatment and Research
2019;96(5):237-249
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Recent studies have analyzed the short-term clinical outcomes of ndovascular management. However, the long-term outcomes are unknown. This study aimed to investigate clinical outcomes after endovascular management for ruptured pseudoaneurysm in patients after pancreaticoduodenectomy (PD). METHODS: The medical records of 2,783 patients who underwent PD were retrospectively reviewed at a single center. Of 62 patients who received intervention after pseudonaeurysm rupture, 57 patients (91.9%) experienced eventual success of hemostasis. The patients were composed as follows: (embolization only [EMB], n = 30), (stent-graft placement only [STENT], n = 19) and (both embolization and stent-graft placement simultaneously or different times [EMB + STENT], n = 8). Long-term complications were defined as events that occur more than 30 days after the last successful endovascular treatment. RESULTS: Among 57 patients, short-term stent-graft related complications developed in 3 patients (5.3%) and clinical complication developed in 18 patients (31.5%). Nine (15.8%) had long-term stent-graft related complications, which involved partial thrombosis in 5 cases, occlusion in 3 cases and migration in 1 case. Except for 1 death, the remaining 8 cases did not experience clinical complications. The stent graft primary patency rate was 88.9% after 1 month, 84.2% after 1 year, and 63.2% after 2 years. Of 57 patients, 30 days mortality occurred in 8 patients (14.0%). CONCLUSION: After recovery from initial complication, most of patients did not experience fatal clinical complication during long-term follow-up. Endovascular management is an effective and safe management of pseudoaneurysm rupture after PD in terms of long-term safety.
