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Treatment Strategies for Management of True Hepatic Artery Aneurysms: A Systematic Review and Meta-Analysis

SHAHAB HAJIBANDEH, Shahin Hajibandeh Orcid Logo, Giorgio Alessandri, Nicola de Liguori-Carino

The American Surgeon™

Swansea University Author: SHAHAB HAJIBANDEH

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DOI (Published version): 10.1177/00031348261425178

Abstract

AimsTo synthesize evidence on outcomes of treatment strategies for management of primary hepatic artery aneurysms (HAAs).MethodsA PRISMA-compliant systematic review was conducted. Due to rarity of the disease, all reported cases which underwent operative or endovascular intervention for true HAA wer...

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Published in: The American Surgeon™
ISSN: 0003-1348 1555-9823
Published: SAGE Publications 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa71509
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spelling 2026-03-17T16:23:52.6590172 v2 71509 2026-02-26 Treatment Strategies for Management of True Hepatic Artery Aneurysms: A Systematic Review and Meta-Analysis b95fa4fe8ce5515ba689c728410200bd SHAHAB HAJIBANDEH SHAHAB HAJIBANDEH true false 2026-02-26 AimsTo synthesize evidence on outcomes of treatment strategies for management of primary hepatic artery aneurysms (HAAs).MethodsA PRISMA-compliant systematic review was conducted. Due to rarity of the disease, all reported cases which underwent operative or endovascular intervention for true HAA were pooled from case reports and case series to create a single cohort of patients. Descriptive statistics, logistic regression models, and Kaplan-Meier statistics were used for analyses.Results62 patients from 41 case reports and one case series were included. The mean age was 60.9 and 77% were male; 66% were symptomatic with pain as the most common symptom (76%). The mean diameter and length of aneurysms were 47.4 mm and 55.8 mm, respectively. The anatomy of aneurysm was hostile in 39% and 11% were ruptured at presentation. In terms of treatment, 74% were treated via operative approach and 26% via endovascular approach. Hostile anatomy was the only predictor for selecting operative approach (OR: 8.72, P = .031). Technical success was achieved in 98%; postoperative mortality and morbidity occurred in 5% and 16%, respectively. The probabilities of graft patency at 60 months were not different between the operative and endovascular approaches (86% vs 90%, P = .961); however, the probability of recurrence-free survival was higher after operative approach (100% vs 85%, P = .046).ConclusionsAccepting type 2 error and confounding by indication as the limitations, both operative and endovascular techniques seem to be safe and feasible in management of true HAA. Hostile anatomy may be the main determinant of selecting operative approach over the endovascular approach. Journal Article The American Surgeon™ 0 SAGE Publications 0003-1348 1555-9823 aneurysms; hepatic artery; endovascular 27 2 2026 2026-02-27 10.1177/00031348261425178 COLLEGE NANME COLLEGE CODE Swansea University SU Library paid the OA fee (TA Institutional Deal) The author(s) received no financial support for the research, authorship, and/or publication of this article. 2026-03-17T16:23:52.6590172 2026-02-26T15:48:10.9746277 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science SHAHAB HAJIBANDEH 1 Shahin Hajibandeh 0000-0001-6159-1068 2 Giorgio Alessandri 3 Nicola de Liguori-Carino 4 71509__36432__6b2b524b163d4ca1a2918edbaca196b5.pdf 71509.VoR.pdf 2026-03-17T16:22:15.9577313 Output 533782 application/pdf Version of Record true © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution 4.0 License. true eng https://creativecommons.org/licenses/by/4.0/
title Treatment Strategies for Management of True Hepatic Artery Aneurysms: A Systematic Review and Meta-Analysis
spellingShingle Treatment Strategies for Management of True Hepatic Artery Aneurysms: A Systematic Review and Meta-Analysis
SHAHAB HAJIBANDEH
title_short Treatment Strategies for Management of True Hepatic Artery Aneurysms: A Systematic Review and Meta-Analysis
title_full Treatment Strategies for Management of True Hepatic Artery Aneurysms: A Systematic Review and Meta-Analysis
title_fullStr Treatment Strategies for Management of True Hepatic Artery Aneurysms: A Systematic Review and Meta-Analysis
title_full_unstemmed Treatment Strategies for Management of True Hepatic Artery Aneurysms: A Systematic Review and Meta-Analysis
title_sort Treatment Strategies for Management of True Hepatic Artery Aneurysms: A Systematic Review and Meta-Analysis
author_id_str_mv b95fa4fe8ce5515ba689c728410200bd
author_id_fullname_str_mv b95fa4fe8ce5515ba689c728410200bd_***_SHAHAB HAJIBANDEH
author SHAHAB HAJIBANDEH
author2 SHAHAB HAJIBANDEH
Shahin Hajibandeh
Giorgio Alessandri
Nicola de Liguori-Carino
format Journal article
container_title The American Surgeon™
container_volume 0
publishDate 2026
institution Swansea University
issn 0003-1348
1555-9823
doi_str_mv 10.1177/00031348261425178
publisher SAGE Publications
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
document_store_str 1
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description AimsTo synthesize evidence on outcomes of treatment strategies for management of primary hepatic artery aneurysms (HAAs).MethodsA PRISMA-compliant systematic review was conducted. Due to rarity of the disease, all reported cases which underwent operative or endovascular intervention for true HAA were pooled from case reports and case series to create a single cohort of patients. Descriptive statistics, logistic regression models, and Kaplan-Meier statistics were used for analyses.Results62 patients from 41 case reports and one case series were included. The mean age was 60.9 and 77% were male; 66% were symptomatic with pain as the most common symptom (76%). The mean diameter and length of aneurysms were 47.4 mm and 55.8 mm, respectively. The anatomy of aneurysm was hostile in 39% and 11% were ruptured at presentation. In terms of treatment, 74% were treated via operative approach and 26% via endovascular approach. Hostile anatomy was the only predictor for selecting operative approach (OR: 8.72, P = .031). Technical success was achieved in 98%; postoperative mortality and morbidity occurred in 5% and 16%, respectively. The probabilities of graft patency at 60 months were not different between the operative and endovascular approaches (86% vs 90%, P = .961); however, the probability of recurrence-free survival was higher after operative approach (100% vs 85%, P = .046).ConclusionsAccepting type 2 error and confounding by indication as the limitations, both operative and endovascular techniques seem to be safe and feasible in management of true HAA. Hostile anatomy may be the main determinant of selecting operative approach over the endovascular approach.
published_date 2026-02-27T05:34:27Z
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