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The development of an iatrogenic pseudoaneurysm is a recognised risk following arterial puncture. Management options include surgery, use of covered stents, ultrasound-guided compression and percutaneous injection of a thrombotic substance such as thrombin. This paper describes an alternative technique using balloon protection and the percutaneous injection of an ethylene vinyl alcohol copolymer, Onyx® (Micro Therapeutics, Inc, Irvine, CA) under ultrasound guidance. This provides a safe and controlled method to occlude the pseudoaneurysm. The advantages of Onyx over other treatment methods are discussed. [Copyright &y& Elsevier]