27 year old Hispanic male presented with 1 month of subjecti | Figure 1

SIRRFS

27 year old Hispanic male presented with 1 month of subjective fevers and night sweats. Clinical labs showed S.viridans in blood and transaminitis. He was subsequently diagnosed with mycotic hepatic artery pseudoaneurysm on Doppler US and CTA. Hepatic arteriogram (A,B) showed a 3cm aneurysm arising from the proximal aspect of the superior branch of the anterior division of the right hepatic artery. The aneurysm was embolized using a detachable coil (C,D). After successful embolization, the contrast can no longer be seen filling the aneurysmal sac (E,F). (Case courtesy Joel Ornelas, MD)

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The hepatic hyperdensities on the previous CT images are arterial aneurysms. Two contrast enhanced images taken at onset of abdominal pain reveal intraparenchymal bleeding consistent w/ rupture. The 1st intervention image shows active extravasation (blue arrows) from R. hepatic branch & multiple L. hepatic branches. The R. hepatic artery branch was embolized first (2nd image). Images 3 & 4 show L. hepatic artery ultra-selective branch coil embolization w/ coil lengths ranging 4-20 mm. Courtesy of Robert Beasley, M.D., Mount Sinai Medical Center of Florida, Dept. of Interventional Radiology.

Perforated cholecystitis leading to hepatic abscesses resulting erosion into hepatic vessels. #Pseudo-aneurysm seen on CTA with hemoperitoneum. Brought to #IRad for #embolization.

History of #endovascular abdominal aortic #aneurysm repair with type II endoleak, meaning enlargement of the aneurysm sac from collateral supply. #Angiography shows feeding arterial feeder coming from right L4 lumbar artery (red arrow). Selective catheterization also shows drainage from right L3 lumbar artery. Coils were placed in the right L3 lumbar artery as well glue #embolization of the right L4 lumbar artery. Completion angiography demonstrates nonfilling of the aneurysm sac. #IRad

#AVF from arterial lines in PICU w/ growing pseudoaneurysm. #Aneurysm and fistula embolized with coils and glue. #RSNA15

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