1.Endovascular and percutaneous embolization of hepatic artery pseudoaneurysm: Etiology, embolic agents and technical success, and experience from a single center
Harish Vasantrao BHUJADE ; Aakash SETHI ; Akshyaya Kumar NAG ; Ujjwal GORSI ; Sunil MARU ; Santhosh IRRINKI ; Naveen KALRA ; Mandeep KANG ; Lileshwar KAMAN
Annals of Hepato-Biliary-Pancreatic Surgery 2026;30(1):42-51
Background:
s/Aims: Hepatic artery pseudoaneurysm (HAP) is a condition associated with high mortality rates when untreated. Current literature lacks comprehensive understanding of complication rates and optimal treatment strategies. This study aims to analyze the etiology, technical success, and complication rates associated with endovascular and percutaneous management of HAP.
Methods:
A retrospective analysis was conducted, examining data on demographics, comorbidities, etiology, and embolic agents. A comparative analysis of hemoglobin levels, liver function tests, and renal function tests was performed before and 24–48 hours after the procedure.
Results:
The study included 49 patients (71% males) with a mean age of 46.44 (± 15.88) years. The common etiologies were post-operative complications (36.7%) and blunt abdominal trauma (26.5%). The right hepatic artery (RHA) was the most frequently involved site (57%). Endovascular embolization involved the use of coils, glue, and stent grafts, while percutaneous embolization was performed in six cases. The technical success rate for the endovascular approach was 97.6%, compared to 33% for the percutaneous approach. Hemoglobin levels stabilized post-procedure (mean post-procedure 8.9 g/dL vs. 7.9 g/dL at presentation), indicating effective hemostasis.Post-procedural complications included transient elevation of liver enzymes (22.4%), hepatic abscess (4.1%), and cholangitis (2.0%).
Conclusions
HAP is primarily caused by iatrogenic injury or blunt abdominal trauma, with a predilection for the RHA. Endovascular therapy proves to be a safe and effective treatment for this life-threatening condition. Although high technical success rates are achievable, the potential for ischemic complications necessitates a tailored treatment approach and the implementation of prophylactic measures when indicated.
2.Hydroxychloroquine for COVID-19: A Single Center, Retrospective Cohort Study
Wen Chung Ho ; Wei Xin Yong ; Khai Shin Tan ; Woh Yon Mak ; Mandeep Kaur Gill ; Agnes Hui Ching Lok ; Shazwani Zulkifli ; Salmah Idris ; Khairil Erwan Khalid ; Chee Loon Leong ; Kang Nien How
Malaysian Journal of Medicine and Health Sciences 2023;19(No.2):8-13
Introduction: The outbreak of coronavirus disease (COVID-19) in December 2019 called for a rapid solution, leading to repurposing of existing drugs. Due to its immunomodulatory effect and antiviral properties, hydroxychloroquine (HCQ) has been used in early 2020 for treatment of COVID-19 patients. This study was conducted to evaluate
the treatment outcome of HCQ monotherapy in Malaysia. Methods: A retrospective cohort study was conducted in
COVID-19 ward in Hospital Kuala Lumpur (HKL), from March to April 2020. A total of 446 COVID-19 patients were
recruited, only 325 patients were finally included for analysis. Statistical analysis was done using SPSS, with a significant value set at p<0.05. Results: The mean age of the patients were 38.5 ±15.5. They were majority male, (n=210,
64.6%) Malaysian (n=239, 73.5%) and Malay ethnicity (n=204, 62.8%). Ninety-one (28%) patients received HCQ
monotherapy. HCQ monotherapy was associated with worse outcome (OR: 10.29, 95% CI 1.17-90.80). There was a
significant difference in mean length of stay between those with and without HCQ treatment (t323=5.868, p<0.001,
95% CI, 2.56-5.31). The average length of stay for HCQ treated group was 3.84 days longer than those without
treatment. 6.6% of the patient receiving HCQ monotherapy encountered adverse drug effects. Conclusion: Similar
to study reported worldwide, our study demonstrated that HCQ did not improve length of stay and the outcome of
COVID-19 patients.


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