An Unusual Complication of Transarterial Chemoembolization of Hepatocellular Carcinoma; Pseudoaneurysm: A Case Report

Background: Transarterial chemoembolization (TACE) is a globally recognised treatment method for hepatic tumors, especially unresectable hepatocellular carcinoma (HCC). Although the technique is relatively safe, it may cause serious complications, such as liver abscess, liver failure, and non-target embolization. Here, the case of a rare complication of TACE is presented. Case Presentation: A-55-year-old male patient was referred to the interventional radiology department for surgically unresectable HCC. CT scan showed a heterogeneously enhancing lesion with capsular enhancement consistent with HCC. On MRI examination, a central necrotic part was seen within the lesion, and TACE was performed. At the end of the TACE, a pseudoaneurysm of the hepatic artery was detected, which was successfully embolized with pushable micro-coils. Conclusion: To the best of our knowledge, very few cases of pseudoaneurysm of the hepatic artery have been described in the literature, and in those cases, the cause has been thought to be guidewire manipulation. In contrast, in the current case, it was thought that it might occur due to central necrosis and central perfusion insufficiency of the lesion. Pseudoaneurysm is a treatable condition with coil embolization.