Endovascular management of a large hepatic artery aneurysm related to type B aortic dissection

Management of visceral artery aneurysms can be challenging: there is limited evidence to determine size thresholds for intervention and it is often technically difficult to exclude the aneurysms while preserving visceral perfusion. We present the case of a 68-year-old male with a rapidly enlarging hepatic artery aneurysm related to type B aortic dissection extending into the coeliac axis, which presented unique difficulties due to its morphology and filling via the false lumen. Endovascular treatment involved stent-graft placement from the coeliac axis into the splenic artery with the intention of excluding the coeliac supply to the common hepatic artery. Despite early stent-graft occlusion, the aneurysm was successfully excluded and adequate hepatic and splenic perfusion was maintained. The patient made a good recovery.