A Rare Complication of Radial Artery Cannulation

Abstract

The radial artery is well known for its consistent anatomic accessibility, ease of cannulation, and low rate of complications, which have made the radial artery the preferred and most common site for arterial cannulation.A 63-year-old woman undergoing elective laparotomy for transabdominal hysterectomy and bilateral salpingo-opherectomy with possible clearance of any other cancerous pelvic mass. After completion of the operation, while removing the arterial catheter, accidental fracture of radial artery catheter during patient transfer, giving rise to an intravascular retained foreign body was noted by the anaesthetist. Successful surgical removal was completed under ultrasound guidance. The retrieval of a retained foreign body in the peripheral arteries under ultrasound guidance is highly recommended. ª

Arterial line fracture: an unusual complication of invasive blood pressure monitoring

“…Many anaesthetists are now sufficiently skilled in ultrasound to identify the presence of an intra-arterial foreign body and refer the patient on as required. As in this case, both Aslam et al [6] and Hamid et al [5] reported migration of the cannula fragment following arteriotomy. This highlights the importance of intra-operative ultrasound as a tool to monitor foreign body location and ensure lack of distal migration.…”

“…Previous cases identified in the literature have utilised several methods of identifying the presence of intra-arterial cannula fragments, including x-ray and angiography [5]. In addition, ultrasound has also been demonstrated to be a useful non-invasive tool to confirm both the presence and location of a foreign body [5][6][7]. Many anaesthetists are now sufficiently skilled in ultrasound to identify the presence of an intra-arterial foreign body and refer the patient on as required.…”