Hepatic artery aneurysm is a rare vascular complication after liver transplantation occurring usually in the first two post-operative months and carries a high mortality rate. Almost all of these aneurysms are pseudo-aneurysms and the majority of them are infected.
Objective: To report the delayed occurrence and successful endovascular stent-graft repair of an aneurysm in a donor iliac artery that was used as an infra-renal jump graft. Case Report: A 55-year-old female underwent cadaveric liver transplantation in 1997 for liver cirrhosis secondary to HCV infection. She had an undetectable HCV PCR level post-operatively on antiviral therapy. The patient presented 8 years later with a vague left upper quadrant abdominal pain that radiated to the back. A CT angio of the abdomen and pelvis revealed an aneurysm in the mid-portion of the infra-renal jump graft with a thrombus causing significant narrowing of the lumen. The patient denied having fevers or chills. Her liver function test was normal with a normal duplex U/S of the liver vessels. The ESR was elevated and blood cultures were negative. The patient underwent an endovascular repair with a stent-graft because of the significant stenosis in the iliac graft. Interestingly, the patient pain resolved after the procedure. She is now 14 months since the procedure, symptom free with a normal liver function. This case might represent the occurrence of an inflammatory aneurysm because of the elevated ESR and the resolution of symptoms after the repair. Endovascular approach was useful in this case. Figures will be included.