Successful surgical treatment of visceral artery aneurysms after failure of percutaneous treatment

We report 2 cases involving aneurysms of visceral arteries that needed surgical treatment after unsuccessful percutaneous treatment. In the 1st case, repeated embolizations with Gianturco coils and angiographic guidewires had failed to obliterate a large aneurysm of the hepatic artery. In the 2nd case, a peripancreatic pseudoaneurysm caused recurrent gastrointestinal bleeding despite embolization with Gianturco coils. In both patients, left medial rotation of the viscera provided access to the origin of the affected artery at the aorta, enabling the surgeon to control bleeding before opening the aneurysm. The advantages and limitations of the most commonly performed percutaneous procedures are discussed, as are the surgical options.