In Reply to: Re: Case 797_07 -- Hepatic artery pseudoaneurysm following biliary drainage posted by Scott Trerotola on July 21, 1997 at 20:50:41:
I agree that there is actually the suggestion of the pseudoaneurysm on the first images. The findings can be quite subtle and multiple magnification views of the areas of the liver traversed by the catheter are useful. Removing the transhepatic catheter over a guidewire may further demonstrate 'occult' lesions.
A cautionary note: I have seen one case of bleeding (fatal) from an hepatic pseudoaneurysm embolization in which the distal portion could not be catheterized and embolized. So I really go to any length to cross the pseudoaneurysm and take out the 'back door' of the lesion as well.
One thing to which I've never heard any definitive answers: after embolizing a catheter related hepatic arterial lesion is it best to remove the catheter or leave it in for some time. I've done both. Dogmatic opinions fall on all sides of this question.