Open surgical resection of giant common hepatic artery aneurysm after failed endovascular repair

Hepatic artery aneurysms represent 20% of visceral artery aneurysms and carry a high risk of fatal outcomes. We describe an 8.6-cm common hepatic artery aneurysm previously treated with endovascular stenting and coiling that progressively enlarged and was complicated by endoleak and mural thrombus. Open partial resection was performed without reconstruction, and the patient made a full recovery with no recurrence at the 2-year follow-up. This case underscores the therapeutic challenges in treating giant aneurysms and highlights the importance of assessing collateral circulation when considering an aneurysmectomy.