Recurrence of Pseudoaneurysm after Successful Embolization

Abstract

Purpose:

To report the initial successful treatment of a hepatic pseudoaneurysm by a partially formed coil and subsequent recurrence secondary to coil migration and configuration change.

Methods and Results:

A 22-year-old man suffered a gunshot wound in the abdomen; a grade 4 liver laceration was identified and repaired. Eight days later, abdominal pain developed, and pseudoaneurysms were noted off both the superior and inferior branches of the right hepatic artery. Coil embolization was successful in occluding both defects; however, the inferior branch coil was incompletely formed. Twenty days later, symptom recurrence prompted angiography. The inferior branch coil had changed position and configuration, resulting in a larger pseudoaneurysm. Repeat embolotherapy was successful.

Conclusions:

The possible sequelae to maldeployed occluding coils must be considered even if the procedure appears successful. It may be advisable to place additional coils to more confidently occlude the pseudoaneurysm.