Fig. 8.

Massive hemobilia after radiofrequency ablation of a liver tumor. ( a and b ) Hepatic angiography shows pseudoaneurysm (PSA) better seen in the delay phase (arrow). ( c ) Angiography after coil embolization shows persistent filling of the PSA (arrow) through multiple small branches of both right and left hepatic arteries. ( d ) PSA was directly punctured with a Chiba needle using ultrasound guidance and a transhepatic percutaneous approach. Contrast opacification of the PSA is seen (arrow) and then thrombin was injected. ( e ) Angiography after thrombin injection shows successful exclusion of the PSA.