Successful Coil Embolization of a Giant Celiac Artery Aneurysm in a Patient With Liver Cirrhosis: A Case Report

TL;DR

A patient with liver cirrhosis successfully underwent celiac artery embolization for a giant aneurysm using detailed preoperative imaging to avoid liver damage.

Contribution

Demonstrates safe celiac artery embolization in liver cirrhosis using 3D CT to assess collateral circulation.

Findings

Preoperative 3D CT showed a replaced right hepatic artery and adequate collateral circulation.

Postoperative imaging confirmed aneurysm shrinkage without worsening liver function.

The procedure was completed with minimal blood loss and no complications.

Abstract

In patients with uncompensated liver cirrhosis, celiac artery embolization poses the risk of hepatic ischemia, which may lead to liver failure. We report a case of coil embolization of a giant celiac artery aneurysm in a 63-year-old man with liver cirrhosis. Preoperative contrast-enhanced and three-dimensional (3D) computed tomography (CT) angiography demonstrated a replaced right hepatic artery arising from the superior mesenteric artery and well-developed collateral circulation to the proper hepatic artery via the pancreaticoduodenal arcade. Based on these findings, coil embolization of the celiac artery was performed under local anesthesia. Intraoperative angiography with temporary balloon occlusion of the celiac artery confirmed adequate collateral hepatic circulation via the superior mesenteric artery before the embolization. Final angiography demonstrated complete elimination of contrast enhancement within the aneurysm. The operative time was 106 minutes, and blood loss was minimal. The postoperative course was uneventful, with no worsening of liver function. Follow-up CT performed one year after the procedure demonstrated aneurysm shrinkage, with the diameter decreasing from 60 × 67 mm to 46 × 50 mm, without progression of liver dysfunction. This case highlights the importance of detailed preoperative vascular evaluation using 3D CT to safely perform celiac artery embolization in patients with liver cirrhosis.

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