Acute Upper-Limb Complications Following Radial Artery Catheterization for Coronary Angiography

Harvey, Jamison A.; Kim, Sarasa; Ireson, Mollie; Gulati, Rajiv; Bell, Malcolm R.; Moran, Steven L.

doi:10.1016/j.jhsa.2019.11.007

Cited by 16 publications

(16 citation statements)

References 20 publications

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“…Coexistent infection may lead to rupture and gross hemorrhage [ 7 ]. Most patients develop symptoms in the first week and do not need observation beyond 60 days [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Radial artery pseudoaneurysm (PSA) after radial access for coronary procedures is an exceptionally rare complication with an incidence of <0.1% and with possible unfavorable results, if left untreated [ 1 ]. Up to date, apart from case reports, only a few large series exist examining the incidence of complications after radial access for coronary angiography [ 1 ]. Additionally, there are no clinical trials regarding the best treatment of PSAs, and consequently no systemic guidelines exist [ 2 - 4 ].…”

Section: Introductionmentioning

confidence: 99%

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A case report of surgical repair of a post-catheterization radial pseudoaneurysm

Papadoulas¹,

Tsantrizos²,

Kouri³

et al. 2022

Pan Afr Med J

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We report an 83-year-old patient with a huge post-catheterization right radial pseudoaneurysm, presented 17 months after a coronary angiography. Cases of radial post-catheterization pseudoaneurysms with a similar size are scarce in the literature. Delay in presentation led to painful skin ischemia due to tension, a sign of imminent rupture, which is also rare in the literature. Symptomatology included severe wrist pain and clinical signs consisted of a pulsatile painful mass in the right distal forearm. Management consisted of surgical excision and ligation of the radial artery in an urgent base. This case emphasizes the need for early diagnosis and management of post-catheterization pseudoaneurysms as delay may lead to severe enlargement with skin necrosis and imminent rupture. Ligation of the radial artery is an acceptable option when reconstruction of the artery is troublesome, provided that the palmar arch remains patent.

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“…Coexistent infection may lead to rupture and gross hemorrhage [ 7 ]. Most patients develop symptoms in the first week and do not need observation beyond 60 days [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A case report of surgical repair of a post-catheterization radial pseudoaneurysm

Papadoulas¹,

Tsantrizos²,

Kouri³

et al. 2022

Pan Afr Med J

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show abstract

“…1,2 The incidence of all vascular complications of the radial artery approach is rare at less than 1%, and the incidence of pseudoaneurysms and AVFs is lower still at less than 0.1% each. [2][3][4] Hematomas are usually diagnosed immediately after or within a few hours of catheterization. 2,4 However, half a day to several days later, pseudoaneurysms are found as pulsatile subcutaneous masses, and AVFs are noticed by a palpable thrill.…”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm and Arteriovenous Fistula in the Radial Artery after Cardiac Catheterization: A Case Report

Maeba

Urata

Nagata

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Summary: We report the case of a 71-year-old man who was experiencing a gradually worsening, dull pain and a cold sensation in his right hand. Three months earlier, he underwent a percutaneous coronary intervention for angina pectoris using a transradial approach in his right wrist and developed an arteriovenous fistula (AVF), a complication of percutaneous coronary intervention. Ultrasonography and computed tomography revealed a pseudoaneurysm and an AVF that were reducing the blood flow in his right hand. We observed that the pseudoaneurysm and the AVF were close to the bifurcation of the superficial palmar artery (SPA) and that the superficial palmar arch had radial artery superiority. Because we thought it was important to maintain the blood flow of the SPA branch, we excised the pseudoaneurysm, sutured the artery directly via microsurgery, and ligated the arteriovenous shunt. After the operation, the patient’s symptoms were alleviated. Computed tomography showed that the blood flow in his right hand was improved and that his right SPA branch from the radial artery was directly fed to the index finger. Because the blood circulation in the hand is dual dominant but with many anatomical variations, we believe that it is important to preserve the blood flow of the SPA in postcatheterization pseudoaneurysm and AVF repair.

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“…Failure of radial artery catheterization can lead to various complications such as vasospasm, local hematoma, and limb distal ischemia. Vasospasm of radial artery in turn can reduce the vascular diameter, change the vascular position, and further increase the difficulty of catheterization, which can even affect the safety of surgery [ 1 , 8 ]. Therefore, searching an appropriate method to increase the diameter of radial artery and reduce the occurrence of vasospasm can improve the success rate of radial artery catheterization and facilitate the rapid recovery of pediatric patients, which is of great significance in the perioperative period.…”

Section: Introductionmentioning

confidence: 99%

Efficacy Assessment of Phentolamine Accompanied by Lidocaine Subcutaneously under Ultrasound Guidance on Radial Artery Catheterization in Pediatric Patients

Kong

Shu

Yuan

et al. 2022

BioMed Research International

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Objective. Pediatric patients are facing greater difficulties in radial catheterization for anatomic variation and smaller diameter. This study is to investigate the efficacy of phentolamine accompanied by lidocaine subcutaneously under ultrasound guidance on radial catheterization in pediatric patients. Methods. 66 pediatric patients were enrolled and randomly divided into saline group, phentolamine group, and phentolamine+lidocaine group. Baseline characteristics and surgical types were collected. Relevant solutions were subcutaneously injected, and catheterization was subsequently conducted under ultrasound guidance. Radial artery diameter and depth were measured, the success rate of catheterization and procedure time were calculated, and the complications were evaluated with ultrasonography. Results. No significant differences were observed in age, sex, weight, American Society of Anesthesiologists’ classification, systolic blood pressure, diastolic blood pressure, heart rate, hemoglobin, and surgical types among three groups. Subcutaneously, the diameter in phentolamine and phentolamine+lidocaine groups increased significantly compared with the saline group. Moreover, the diameter also increased significantly after injection compared with that before injection both in the phentolamine and phentolamine+lidocaine groups. The first-attempt success rates were significantly higher while the procedure times of cannulation were shorter in the phentolamine and phentolamine+lidocaine groups than that in the saline group. Kaplan–Meier analysis showed that the overall procedure time was shorter in the phentolamine and phentolamine+lidocaine groups than the saline group. Overall complications and vasospasm incidence were lower in the phentolamine and phentolamine+lidocaine groups than the saline group. Conclusion. Phentolamine accompanied by lidocaine subcutaneous injection under ultrasound guidance improved the first-attempt success rate and reduced the complication of radial artery catheterization in pediatric patients.

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Acute Upper-Limb Complications Following Radial Artery Catheterization for Coronary Angiography

Cited by 16 publications

References 20 publications

A case report of surgical repair of a post-catheterization radial pseudoaneurysm

A case report of surgical repair of a post-catheterization radial pseudoaneurysm

Pseudoaneurysm and Arteriovenous Fistula in the Radial Artery after Cardiac Catheterization: A Case Report

Efficacy Assessment of Phentolamine Accompanied by Lidocaine Subcutaneously under Ultrasound Guidance on Radial Artery Catheterization in Pediatric Patients

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