Percutaneous Embolization of a Hepatic Artery Pseudoaneurysm under Combined

Hepatic artery pseudoaneurysm is a rare complication of liver directed procedures. Several strate-gies for treatment of pseudoaneurysms have been described. We describe a challenging case in which a small bleeding hepatic artery pseudoaneurysm is complicated by a proximal hepatic ar-terial occlusion, preventing transcatheter access. The aneurysm was too small to be seen on ul-trasound. Using combined angiographic and fluoroscopic guidance, however, the aneurysm was triangulated and successfully treated with percutaneous direct thrombin injection. Combined an-giography and fluoroscopy guided percutaneous thrombin injection of intrahepatic pseudoaneu-rysms can be a valuable treatment approach, particularly when other methods are not feasible or have failed