Fatal arterial hemorrhage after pancreaticoduodenectomy: How do we simultaneously accomplish complete hemostasis and hepatic arterial flow?

Table 3 Endovascular treatment

Case number	Treated artery (target and range)	TAE	Stent-graft placement			Technical success during EVT	Reasons for failed or incomplete EVT	Additional surgical approaches (day number2)	Additional EVT (day number2)	Antiplatelet and/or anticoagulation agents (number)	Long-term results of EVT
											TAE		Stent-graft placement
			Stent type (number1)	Size (mm)	Length (mm)						Collateral circulation (yr)3	Recanalization (yr)3	Patency (y)3
1	RGA	Coiling	-			Yes	-	No	No	No	No (4.39)	No (4.39)	-
2	CA; SA	-; Coiling	Covered stent (1); -	3.5; -	19; -	No	Stenosis	Hemostasis (-7 and -6)	Stent regrafting (+ 1); Coiling (+ 1)	No	-	-	-
3	PHA-LHA	-	Covered stent (1)	3.5	19	Yes	-	No	No	Yes (1)	-	-	Patent (0.72)
4	SMA branch; RHA	Coiling; -	-; Covered stent (1)	-; 3.5	-; 19	Yes	-	Lavage and cholangio-jejunal anastomosis (+ 7)	Stent regrafting (+ 28)	No	No (6.14); -	No (6.14); -	-; Patent (6.14)
5	SA branch	Coiling	-			Yes	-	No	No	Yes (1)	No (0.46)	No (0.46)	-
6	CHA-PHA	-	Covered stent (1)	3.5	19	Yes	-	No	No	No	-	-	Patent (0.93)
7	RHA	-	Covered stent (1)	3.5	19	Yes	-	Lavage and cholangio-jejunal anastomosis (+ 3)	No	No	-	-	Patent (1.27)
8	GDA	Coiling	-	-	-	No	Subtle bleeding4	No	No	No	No (0.24)	No (0.24)	-
9	DPA	Coiling	-	-	-	Yes	-	No	No	No	No (0.44)	No (0.44)	-
10	-	-	-	-	-	No	Stenosis	Hemostasis and ligation of CHA (± 0)	No	Yes (2)	-	-	Patent (1.95)
11	RHA	-	Covered stent (2)	3.0	19	Yes	-	Removal of hematoma (- 18)	Stent regrafting (+33)	Yes (2)	-	-	Patent (1.53)
12	CHA-PHA	-	Covered stent (1)	3.5	19	Yes	-	Removal of hematoma (± 0)	No	No	-	-	Patent (0.98)
13	CHA-PHA	Coiling	-	-	-	Yes	-	No	No	No	Yes (1.53)	No (1.53)	-
14	GDA	Coiling	-	-	-	No	Difficulty in packing	Arterio-portal shunting5 (+ 4)	CHA coiling (+ 4)	Yes (1)	Yes (7.72)	No (7.72)	-
15	GDA	-	Covered stent (1)	3.5	19	Yes	-	No	No	No	-	-	Patent (0.00)
16	GDA	-	Covered stent (2)	2.6	19	Yes	-	Removal of hematoma (± 0)	No	No	-	-	Patent (0.01)

¹The second stentgraft was implanted in overlapping fashion.

²The day number from the initial endovascular treatment (EVT).

³Findings in the latest dynamic image studies (time from the initial EVT).

⁴Subtle bleeding was observed at the end of EVT, but thereafter, complete hemostasis was fainally obtained.

⁵Shunt creation between the iliocecal artery and vein. CA: Celiac artery; CHA: Common hepatic artery; EVT: Endovascular treatment; GDA: Gastroduodenal artery; LHA: Left hepatic artery; RHA: Right hepatic artery; PHA: Proper hepatic artery; RGA: Right gastric artery; SA: Splenic artery; SMA: Superior mesenteric artery; TAE: Transcatheter arterial embolization.