Did You Say “Flexible”?

Abstract

A 48 year old patient was referred with a 45 mm post-anastomotic dilation of a retrograde venous aortohepatic bypass (A) performed four years ago for hepatic ischaemia. Endovascular treatment was preferred because of a persistent thrombocytopenia. An “endo-bypass” using 7 and 6 mm Viabahn stent grafts (W.L. Gore & Associates, Flagstaff, AZ, USA) and common hepatic artery embolisation (6 mm Amplatzer Vascular Plug 4; Abbott Vascular, Santa Clara, CA, USA) were performed to exclude the aneurysm with an adequate sealing zone. One year computed tomography angiography showed thrombosis of the venous bypass aneurysm, satisfactory stent patency, and a collateral arterial network to the spleen (B).