Both causes of the pseudoaneurysm in my patient can be true. She was involved in the MVA, had lung contusion, and your case confirms the fact that it could be a result of blunt injury to the artery. She also had a right IJ vein introducer placement which allegedely was uncomplicated. Duplex revealed a pseudoaneurysm with a distinct neck. Angio confirmed it. Pseudoaneurysm was located about 4 cm distal to the vertebral artery takeoff. This location would rather be attributed to a catheterization mishap.
Right after I posted the case, my intern who continued a MEDLINE search ran into a following reference:
Treatment of iatrogenic femoral artery pseudoaneurysm with percutaneous thrombin injection
Chiau-Suong Liau, MD, Feng-Ming Ho, MD, Ming-Fong Chen, MD, PhD, and Yuan-Teh Lee, MD, Taipei and Tau-Yuen, Taiwan
And that was what we did. Patient was still on the angio table. Interventional radiologist occluded Rt subclavian artery with a balloon at the pseudoaneurysm neck, Doppler confirmed no flow in the aneurysm. Under U/S guidance, we catheterized aneurysm and injected Thrombin. Minutes later, there was no Doppler detectable flow within the pseudoaneurysmal sack and angio confirmed that with good patency of the arm vessels.