# Successful Surgical Treatment for Large Common Hepatic Arterial Aneurysm Incidentally Discovered during Evaluation for Mallory–Weiss Syndrome

## TL;DR

A large hepatic artery aneurysm was successfully treated using a hybrid surgical approach, highlighting the importance of tailored treatment strategies.

## Contribution

A novel hybrid surgical technique combining open ligation and balloon occlusion is proposed for complex hepatic artery aneurysm cases.

## Key findings

- A hybrid approach enabled safe aneurysm exclusion without hepatic ischemia.
- Anatomical complexity necessitates individualized treatment selection for optimal outcomes.

## Abstract

Although both open and endovascular repair are available for hepatic artery aneurysms (HAAs), the optimal treatment strategy remains controversial, particularly in anatomically complex cases. In the present case, a large common HAA measuring 100 × 49 mm with a short proximal neck posed significant challenges for both modalities. To ensure intraoperative hemostasis, a hybrid approach was adopted: open surgical ligation combined with prophylactic balloon occlusion at the aneurysmal neck. This strategy enabled safe exclusion of the aneurysm without hepatic ischemia. The case underscores the importance of selecting open, endovascular, or hybrid techniques based on individual anatomical complexity to optimize outcomes in HAA management.