We read with great interest the report by Elias et al. 1 of endovascular exclusion of a hepatic artery pseudoaneurysm (HAP) using a polytetrafluoroethylene-covered stent (Jomed NV). The authors commented that "surgical intervention to and around the hepatic artery" is the most common cause of HAP. However, with liver transplantation, the hepatic artery is by definition manipulated, and it has been our experience as well as others' that a local infection, particularly from bile leaks adjacent to the artery, is the most common etiology of HAP. 2,3 Therefore, it would have been helpful if the authors had provided additional details of the postoperative course, including presence or absence of local infection. We also note with interest that this patient had an active infectious source (osteomyelitis requiring amputation) just 2 weeks prior to transplantation. We believe that the optimum approach in a patient with mycotic aneurysm will be a procedure that will resect or exclude the pseudoaneurysm and resolve the bile leak or other cause of local infection. Although there are a few case reports of polytetrafluoroethylene-covered stents being used to treat mycotic pseudoaneurysms in the femoral, pulmonary, and renal arteries and thoracic aorta, 4 the experience is limited, and stents seem to be advisable when the patient is at high risk for surgery.