Balloon-Assisted Percutaneous Thrombin Injection for Treatment of Iatrogenic Left Subclavian Artery Pseudoaneurysm in a Critically Ill COVID-19 Patient

Figure 3

(a, b) Pigtail catheter (blue arrow) arteriogram showed pseudoaneurysm (white arrow) arising from the proximal part of the left subclavian artery (red arrow) distal to the origin of the left vertebral artery (black arrow). (c) Angioplasty balloon-tipped catheter (yellow arrow) covering the neck of the pseudoaneurysm. Bedside ultrasound documents the absence of the flow within the pseudoaneurysm by inflating the balloon, and injection of thrombin was done under ultrasound guidance ((c) and US). (d) Arteriogram after the thrombin injection shows no pseudoaneurysm, and it shows the left subclavian artery (red arrow), left vertebral artery (black arrow), and left internal mammary artery (green arrow).

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