Endovascular treatment of life-threatening pseudoaneurysm of the hepatic artery after pancreaticoduodenectomy.

Pseudoaneurysm is a life-threatening complication after pancreaticoduodenectomy. An endovascular covered stent was employed for treatment of pseudoaneurysm of the common hepatic artery after pancreaticoduodenectomy. A 77-year-old female underwent pylorus-preserving pancreaticoduodenectomy for lower bile duct cancer. She complained of hematochezia but upper gastrointestinal endoscopy did not find a bleeding source. Angiography was performed and pseudoaneurysm of the common hepatic artery was discovered. Since no collateral perfusion to the liver was detected, embolization of the common hepatic artery was considered to expose the patient to the danger of severe hepatic dysfunction. Successful exclusion of the pseudoaneurysm was completed with an endovascular covered stent. Inflow of the hepatic artery was secured and no hepatic dysfunction developed. Patency of the stent was confirmed at 5 months follow-up. An endovascular covered stent can be a feasible modality for selected cases of the hepatic arterial pseudoaneurysm.