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Recurrence of pseudoaneurysm after successful embolization
Summary
A hepatic pseudoaneurysm initially treated with a partially formed coil recurred due to coil migration. Repeat embolotherapy successfully treated the recurrent pseudoaneurysm, highlighting the need for secure coil placement in vascular interventions.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Trauma Surgery
Background:
- Hepatic pseudoaneurysms can arise from liver trauma.
- Coil embolization is a standard treatment for pseudoaneurysms.
- Incomplete coil formation can lead to treatment failure.
Observation:
- A 22-year-old male presented with a grade 4 liver laceration post-gunshot wound.
- Pseudoaneurysms developed in the right hepatic artery branches post-repair.
- Initial coil embolization of the inferior branch was suboptimal due to incomplete coil formation.
Findings:
- The incompletely formed coil migrated and changed configuration, causing pseudoaneurysm recurrence.
- Repeat angiography confirmed pseudoaneurysm enlargement.
- Successful repeat embolotherapy achieved definitive occlusion.
Implications:
- The potential for coil migration and configuration changes must be considered in embolization procedures.
- Secure deployment and potentially additional coils may be necessary for robust pseudoaneurysm occlusion.
- This case underscores the importance of vigilant follow-up after interventional procedures for vascular defects.