Percutaneous and endovascular embolization of ruptured hepatic artery aneurysm

A 72-year-old woman presented with an intraperitoneal hemorrhage from a ruptured intrahepatic artery aneurysm, with an associated pseudoaneurysm developing a high-flow arteriovenous fistula. Persistent coagulopathy and a median arcuate ligament stenosis of the celiac axis further complicated endovascular management. Aneurysm thrombosis required percutaneous embolization with coils, a removable core guidewire and polyvinyl alcohol particles.