CTICasesAxillary Impella Insertion Site Pseudoaneurysm
Imaging findings
Contrast-enhanced CT of the chest and upper extremity shows a lobulated, enhancing pseudoaneurysm arising from the right axillary artery at the insertion site of a recently removed Impella mechanical circulatory support device, accompanied by surrounding soft tissue hematoma.
Key takeaways
Pseudoaneurysms are a known vascular complication at the arteriotomy site of large-bore sheaths used for devices like the Impella. Direct inspection of the access site on CT is indicated when patients present with a post-procedure drop in hematocrit, localized pain, or a pulsatile mass.
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