Why the study?
Inadvertent arterial puncture during percutaneous venous access for pacemaker insertion is a rare complication that can lead to pseudoaneurysm formation, particularly without ultrasound guidance.
Endovascular covered stent placement combined with Tisseel injection is a viable management strategy for iatrogenic axillary artery pseudoaneurysms complicating pacemaker insertion.
May be considered for iatrogenic axillary pseudoaneurysms after pacemaker placement; extends endovascular options while remaining hypothesis-generating.
Percutaneous upper extremity venous access is currently the preferred approach for pacemaker insertion. A potential but rare complication is inadvertent needle puncture of an associated artery instead of the targeted vein, more so when the puncture is attempted without ultrasonography leading to formation of a pseudoaneurysm. Here, in this case report, we discuss a frail 69-year-old male patient having multiple comorbidities presenting with a tender gradually progressive right axillary swelling which he noticed following a pacemaker insertion 2 months ago. On evaluation, it was diagnosed to possibly be an iatrogenic pseudoaneurysm. He was managed using an endovascular procedure in the form of covered stent placement under fluoroscopic guidance in addition to Tisseel injection.
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Budihal et al. (2026) studied this question.
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