Iatrogenic arterial dissection leading to radiation induced arteritis following transarterial radioembolization

Abstract We herein describe the case of a 71-year-old man with hepatocellular carcinoma in segment VIII treated with transarterial radioembolization (TARE) complicated by focal iatrogenic dissection leading to radiopharmaceutical pooling on the arterial lumen at the level of the hepatic hilum. Seven days later, radiation-associated arteriopathy was documented on contrast-enhanced CT with multiple erosions and pseudoaneurysms of the right hepatic artery and its branches, necessitating urgent endovascular embolization to successfully exclude the pathological vessels. This case highlights a rare vascular complication following TARE and underscores the importance of reconsidering treatment delivery in the presence of vascular abnormalities.