title: Hemorrhage from a right hepatic artery pseudoaneurysm: endovascular treatment with a coronary stent-graft.
abstract: OBJECTIVE
  To report a novel case demonstrating the successful endovascular treatment of a right hepatic artery pseudoaneurysm using a balloon-expandable coronary stent-graft.
  
  
  METHODS
  A 60-year-old woman underwent surgical treatment for a Klatskin tumor, but her postoperative course was complicated by serious blood loss. An emergent celiac angiogram through a right transfemoral approach demonstrated a small iatrogenic pseudoaneurysm in the proximal right hepatic artery. A 7-F guiding catheter was positioned at the origin of the celiac trunk, and a Jostent coronary stent-graft mounted on a 2.7-F, 4-mm x 30-mm balloon catheter was successfully placed across the aneurysm neck. The final angiogram demonstrated total exclusion of the pseudoaneurysm with preservation of the arterial lumen. The hemodynamic condition of the patient became stable. At 12-month follow-up, duplex scanning confirmed regular right hepatic artery patency and absence of thrombotic tissue or signs of infection around the stent-graft.
  
  
  CONCLUSIONS
  For hepatic artery pseudoaneurysms, endovascular repair using small covered stents may be a viable alternative to transcatheter embolization. The use of coronary instruments facilitates treatment of vascular lesions in small caliber visceral vessels.
authors: Department of Radiology, Scientific Institute S. Raffaele, University Hospital, Milan, Italy. radiologia@hsr.it
authors: Massimo
authors: M
authors: Venturini
authors: Enzo
authors: E
authors: Angeli
authors: Marco
authors: M
authors: Salvioni
authors: Francesco
authors: F
authors: De Cobelli
authors: Chiara
authors: C
authors: Trentin
authors: Michele
authors: M
authors: Carlucci
authors: Carlo
authors: C
authors: Staudacher
authors: Alessandro
authors: A
authors: Del Maschio
mesh_terms: D017541:Aneurysm, False / Q000150:complications* / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D002404:Catheterization; D005260:Female; D006470:Hemorrhage / Q000209:etiology* / Q000628:therapy*; D006499:Hepatic Artery; D006801:Humans; D007049:Iatrogenic Disease; D008875:Middle Aged; D015607:Stents