Double lumen dialysis catheter was inserted via the right internal jugular vein by the vascular surgeon under imaging guidance, for dialysis (the patient had an AV fistula in the left arm which was not still mature for dialysis). Iatrogenic pseudoaneurysm of the right internal mammary artery was diagnosed with CT chest which was later on treated was endovascular coil embolization by the interventional radiologist.  

Internal mammary artery (IMA) pseudoaneurysm is an uncommon vascular complication that frequently occurs after penetrating chest wall trauma, sternotomy, percutaneous biopsy, drainage, subclavian central venous line or cardiac pacemaker insertion (iatrogenic) or chest wall infection (tuberculosis, fungus, actinomycosis, or staphylococcus) ^1,2. Symptomatic pseudoaneurysms need treatment. In the past, they were managed with conventional surgical repair (invasive approach associated with higher morbidity & mortality); however, due to recent technological developments in the interventional radiology, transcatheter endovascular coil embolization (minimally invasive approach), is currently the preferred safe & effective alternative management option. With this technique, the coils can be placed either within the pseudoaneurysm or in the feeding blood vessel of the pseudoaneurysm ^1,2.

Case courtesy of Dr. Zahid Anwar Khan (consultant interventional radiologist).