Hepatic artery pseudoaneurysm coiling
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Acute on chronic pancreatitis with upper GI bleed
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Fairly large pseudoaneurysm arising inferomedially at the common hepatic artery trifurcation. The left hepatic artery is taking off superomedially opposite the gastroduodenal. It has a narrow neck.
The celiac axis had a right angle take off from the aorta. Hence a Sim 1 catheter is used to cannulate the celiac axis. After confirming the presence of a narrow-necked pseudoaneurysm arising from the common hepatic artery trifurcation. The pseudoaneurysm is super selectively cannulated with a Progreat (Terumo) microcatheter. Microcoils (Hilal, COOK - ). 18", 3mmx30mm coils are deployed at the neck of the pseudoaneurysm.
Complete exclusion of the pseudoaneurysm is achieved.
One of the microcoil has migrated into the distal right hepatic arterial branch.
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