Successful embolization assisted by covered stents for a pseudoaneurysm following pancreatic surgery

Figure 1 Abdominal computed tomography. Narrowing of the common hepatic artery and a 7.0 cm × 7.0 cm huge mass with no contrast (arrowheads) extending into the ventral and cranial aspect of the constriction of the common hepatic artery (arrows).

Figure 2 Placement of covered stent graft for pseudoaneurysm of common hepatic artery. A: Angiography revealed a pseudoaneurysm arising at the common hepatic artery (white arrows) and the dilated lumen of the common hepatic artery (arrowheads); B: A guide wire was advanced past the pseudoaneurysm and a 4 mm x 14 mm covered stent was deployed (arrows); C: Angiography revealed extravasation of contrast medium from the proximal edge of the covered stent (arrow). A dehiscence seemed to occur at the fragile arterial wall; D: An additional covered stent (arrows) was placed partly under lapping the first stent (black arrows).

Figure 3 Both hemostasis and blood flow to the liver was confirmed by angiography.

Figure 4 Microcoil embolization in the lumen of the covered stent. A: Angiography revealed a pseudoaneurysm in the proper hepatic artery at the distal edge of the covered stent (arrows); B: Arteriogram shows the complete exclusion of the common hepatic artery, complete cessation of bleeding and blood flow to the liver via the anastomotic branch of the left gastric artery.