Right subclavian angiogram demonstrates bleeding from the superior (highest) intercostal arising from the costo-cervical trunk. A series of a small pseudo-aneurysms were present and active bleeding at the time of angiography. The common trunk leading to the site of the bleeding, the highest intercostal was embolised with a series of 2 mm coils without compromise of the costocervical trunk. Post embolisation there was cessation of bleeding.
Images courtesy Dr Alex Rhodes, The Royal Melbourne Hospital.