To illustrate various endovascular options of extrahepatic Hepatic Artery Pseudoaneurysms (eHAPAs) treatment considering the advantages and limitations of each approach.

Pseudoaneurysms are vascular lesions that develop from the rupture of the intimal and medial layers of the arterial wall and consequently do not contain any epithelialized wall. This allows differentiation from true aneurysms, which, in contrast, retain all three layers of the vascular wall. Abdominal visceral pseudoaneurysms arise from splanchnic circulation and renal arteries [2].Among abdominal visceral pseudoaneurysms, eHAPAs represent a considerable proportion, with an incidence of 3.4 - 4%; they are a condition often resulting from iatrogenic injury, liver trauma, and acute or chronic...

IMAGING Multi-Detector Computed Tomography (MDCT) with angiographic reconstructions (computed tomography angiography, CTA) is the gold-standard imaging technique for diagnosis and treatment planning. CTA should be performed in both arterial and venous phases since some pseudoaneurysms with a narrow neck are better visualised in the venous phase. Subsequent processing with Maximum Intensity Projection (MIP) and volume rendering reconstruction (VRT) can aid in visualisation and more accurately determine the location and origin of the pseudoaneurysm. Ultrasound (US) plays a less prominent role and is usable in the...

The endovascular treatment of eHAPAs is a valid alternative to surgery because of its minimally invasive nature: it has a lower risk of major complications, shorter hospitalisation time and similar procedural success rate compared to open repair.Interventional radiology techniques are increasingly being employed as first line treatment: the choice of the preferred endovascular technique should be carefully made based on the individual anatomical characteristics.

F. Labella: Nothing to disclose M. G. Riga: Nothing to disclose S. Groff: Nothing to disclose G. Barbiero: Nothing to disclose M. Battistel: Nothing to disclose G. De Conti: Nothing to disclose

[1] Rossi, Michele et al. “CIRSE Standards of Practice for the Endovascular Treatment of Visceral and Renal Artery Aneurysms and Pseudoaneurysms.” Cardiovascular and interventional radiology, 10.1007/s00270-023-03620-w. 29 Nov. 2023, doi:10.1007/s00270-023-03620-w[2] Madhusudhan, Kumble Seetharama et al. “Interventional Radiology in the Management of Visceral Artery Pseudoaneurysms: A Review of Techniques and Embolic Materials.” Korean journal of radiology vol. 17,3 (2016): 351-63. doi:10.3348/kjr.2016.17.3.351[3] Chaer, Rabih A et al. “The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms.” Journal of vascular surgery vol. 72,1S...