Late Recurrence of a Hepatic Artery Aneurysm Seven Years After Initial Coil Embolization: A Combined Endovascular Management

Hepatic artery aneurysms (HAAs) are rare but potentially fatal vascular lesions. Endovascular treatment is the current standard of care, but concerns remain regarding its long-term durability. Recurrence after initial coil embolization, although uncommon, can occur several years later and poses significant re-treatment challenges. We report the case of an 83-year-old male patient with a large recurrent HAA detected seven years after initial coil embolization. The patient was asymptomatic at recurrence and was treated with a combined endovascular approach, including supplementary coil embolization of the aneurysm sac and deployment of a covered stent to exclude the lesion while preserving distal hepatic arterial flow. This case highlights the potential for very late recurrence following coil embolization and underscores the importance of prolonged imaging surveillance. Combined endovascular therapy can provide safe and effective aneurysm exclusion in complex recurrent cases.