Radial pseudoaneurysm in elderly: a rare event with undefinied therapeutical approach. A case report and literature review

Gallinoro, Emanuele; Natale, Francesco; D’Elia, Saverio; Golino, Paolo; Cimmino, Giovanni

doi:10.4081/monaldi.2019.1109

Cited by 6 publications

(8 citation statements)

References 10 publications

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“…Diagnosis is usually confirmed with color duplex. Specifically, the duplex depicts an anechoic mass with bidirectional internal flow (the “ying-yang” and “to-and fro” signs) [ 2 , 3 ]. Treatment aims to terminate the communication between the artery and the sac.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

“…This also may happen in case of long narrow necks, and low flow volumes, in which case observation is suggested [ 2 ]. If they remain unchanged local compression can be applied [ 3 ]. This could be performed continuously with a compression bandage, a simple hemostatic device or a pneumatic one, over the PSA.…”

Section: Discussionmentioning

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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“…In the upper limb, the radial and brachial arteries are the most common puncture sites, but the ulnar artery is also increasingly used [8-10, 20, 21]. Radial and ulnar punctures have a lower major complication rate than brachial and femoral punctures [9,10,[20][21][22][23]. Two complications related to radial and ulnar puncture, spasm and occlusion, should be highlighted [20][21][22][23], but they rarely cause clinical symptoms as the hand has a dual arterial blood supply.…”

Section: Discussionmentioning

confidence: 99%

“…Radial and ulnar punctures have a lower major complication rate than brachial and femoral punctures [9,10,[20][21][22][23]. Two complications related to radial and ulnar puncture, spasm and occlusion, should be highlighted [20][21][22][23], but they rarely cause clinical symptoms as the hand has a dual arterial blood supply. The incidence of radial and ulnar PSA is low, less than 0.1% [20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

“…Two complications related to radial and ulnar puncture, spasm and occlusion, should be highlighted [20][21][22][23], but they rarely cause clinical symptoms as the hand has a dual arterial blood supply. The incidence of radial and ulnar PSA is low, less than 0.1% [20][21][22][23]. Major complications associated with the brachial approach include local thrombus formation, PSA, and nerve compression by hematoma and/or PSA [8,10].…”

Section: Discussionmentioning

confidence: 99%

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Incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center

et al. 2021

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Purpose To evaluate factors associated with pseudoaneurysm (PSA) development. Methods Between January 2016 and May 2020, 30,196 patients had invasive vascular radiological or cardiac endovascular procedures that required arterial puncture. All patients with PSA were identified. A matched (age, gender, and type of the procedure) control group of 134 patients was created to reveal predictors of PSA formation. Results Single PSAs were found in 134 patients. Fifty-three PSAs developed after radiological procedures (53/6555 [0.8%]), 31 after coronary artery procedures (31/18038 [0.2%]), 25 after non-coronary artery cardiac procedures (25/5603 [0.4%]), and 25 due to procedures in which the arterial puncture was unintended. Thirty-four PSAs (25.4%) were localized to the upper extremity arteries (vascular closure device [VCD], N = 0), while 100 (74.6%) arose from the lower extremity arteries (VCD, N = 37). The PSA prevalence was 0.05% (10/20478) in the radial artery, 0.1% (2/1818) in the ulnar artery, 1.2% (22/1897) in the brachial artery, and 0.4% (99/22202) in the femoral artery. Treatments for upper and lower limb PSAs were as follows: bandage replacement (32.4% and 14%, respectively), ultrasound-guided compression (11.8% and 1%, respectively), ultrasound-guided thrombin injection (38.2% and 78%, respectively), and open surgery (17.6% and 12%, respectively). Reintervention was necessary in 19 patients (14.2%). The prevalence of PSA for the punctured artery with and without VCD use was 37/3555 (1%) and 97/27204 (0.4%), respectively (OR, 2.94; 95% CI, 1.95–4.34; P<0.001). The effect of red blood cell (RBC) count (P<0.001), hematocrit value (P<0.001), hemoglobin value (P<0.001), international normalized ratio (INR; P<0.001), RBC count—INR interaction (P = 0.003), and RBC count—VCD use interaction (P = 0.036) on PSA formation was significant. Conclusion Patients in whom the puncture site is closed with a VCD require increased observation. Preprocedural laboratory findings are useful for the identification of patients at high risk of PSA formation.

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Radial artery pseudoaneurysm a rare complication after coronary angiography: A case report and systematic review of the reported cases

Alqahtani

2024

Clinical Case Reports

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Key Clinical MessageThis is a case of 83 years old male who had radial artery pseudoaneurysm after cardiac catheterization. The diagnosis was through Doppler ultrasound and the patient was treated with thrombin injection and reported good outcomes. The literature also included 41 cases of pseudoaneurysm after catheterization. The mean age of patients was 68.5 years with a male prevalence of 49%. Onset of pseudoaneurysm ranged from 0 days (directly after the catheterization) to 150 days with a median of 5 days. The treatment of patients was mainly surgical (19 cases) followed by compression (either manual or TR band) (12 cases), thrombin injection (four cases), compression then surgery (three cases), compression then thrombin injection (one case), percutaneous endovascular repair using a covered stent (one case) and not reported in one case. All cases recovered well.

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Radial pseudoaneurysm in elderly: a rare event with undefinied therapeutical approach. A case report and literature review

Cited by 6 publications

References 10 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

Incidence of and predisposing factors for pseudoaneurysm formation in a high-volume cardiovascular center

Radial artery pseudoaneurysm a rare complication after coronary angiography: A case report and systematic review of the reported cases

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