Endovascular repair of a common hepatic artery aneurysm using overlapping self-expanding covered stent grafts

Hepatic artery aneurysms are uncommon but clinically important because rupture is associated with high mortality. A 69-year-old asymptomatic man was referred after medical screening ultrasound study suggested a pancreatic head mass. Computed tomography demonstrated a 43-mm true common hepatic artery aneurysm. Endovascular repair with self-expanding covered stent grafts was performed after coil embolization of the gastroduodenal artery. Intraoperative angiography revealed a type III endoleak at the overlap zone, which resolved after balloon molding with an angioplasty balloon catheter. The postoperative course was uneventful. At the 3-year follow-up, computed tomography showed no aneurysm enlargement or endoleak, with preserved hepatic arterial flow.