Endovascular treatment of a bleeding portal vein pseudoaneurysm and stenosis secondary to lymphoma infiltration of the liver hilum

The purpose of this report is to describe our experience in the endovascular treatment of a bleeding portal vein pseudoaneurysm with the stent assisted coil embolization technique on a 67-year old patient with a history of lymphoma infiltration of the liver hilum. The patient was asymptomatic for seven months following the procedure and then went on to have variceal bleeding resulting from encasement of the portal vein by recurrent lymphoma. The high grade stenosis was recanalised with a self expanding metal stent and balloon angioplasty which relieved the portal pressure gradient. The patient did not have any further symptoms of bleeding or portal hypertension during the 14 months of follow-up since the second intervention.To our knowledge this is the first report of a portal vein pseudoaneurysm, the first report of the endovascular treatment of a portal vein pseudoaneurysm and the first report of portal vein stenting for the palliation of variceal bleeding second to lymphoma encasement of the portal vein.