Recommendations
10
Hepatic Artery Aneurysm (HAA)
Recommendation
Grade/
LOE
3. Treatment options
3.1 We recommend an endovascular-first approach to all HAAs if it is
anatomically feasible (ie, if this approach maintains arterial circulation
to the liver).
1-A
3.2 In patients with extrahepatic aneurysms, we recommend open and
endovascular techniques to maintain liver circulation.
1-A
3.3 In patients with intrahepatic aneurysms, we recommend coil
embolization of the affected artery (Grade 1B). In patients with large
intrahepatic HAA, we recommend resection of the involved lobe of
liver to avoid significant liver necrosis (Grade 1C).
1-B
1-C
4. Screening for concomitant aneurysm and vascular disease
4.1 We suggest abdominal axial imaging to screen for concomitant
intraabdominal aneurysms in patients who did not have CTA at the
time of HAA diagnosis.
2-B
4.2 We suggest one-time screening CTA or MRA of the head, neck, and
chest for those patients with nonatherosclerotic causes of HAA.
2-B
5. Follow-up and surveillance
5.1 We suggest annual follow-up with CTA or non-contrast-enhanced CT
to observe patients with asymptomatic HAA.
2-B
(cont'd)
