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Vol 23, No 4 (2017)
Case report
Published online: 2017-12-28
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Radial artery pseudoaneurysm (RAP) following transradial intervention — an extremely rare complication successfully managed by surgery: case report

Santosh Kumar Sinha, Mukesh Jitendra Jha, Vikas Mishra, Mahmadula Razi, Anupam Mahrotra, Mohammad Asif, Nasar Abdali, Vikas Chaturvedi, Lokendra Rekwal
DOI: 10.5603/AA.2017.0018
·
Acta Angiologica 2017;23(4):165-169.

open access

Vol 23, No 4 (2017)
Case reports
Published online: 2017-12-28

Abstract

The transradial access for diagnostic and therapeutic purpose is becoming increasingly popular, mainly because of its lack of complications. Radial artery pseudoaneurysm (RAP) is an extremely rare complication, so many of its clinical features are unknown and treatment is not systematic. Therapeutic options are conservative management, ultrasound-guided compression, thrombin injection and surgical intervention. Here, we report a 43-year old female who underwent transradial percutaneous angioplasty of left anterior descending artery. During cannulation of her radial artery, multiple puncture attempts were done. Upon removal of the transra¬dial compression band (TR Band), forearm ecchymosis and small hematoma were noted with mild pain. Tight compression bandage was applied but on the following day, she had complaints of increasing right forearm pain and tenderness. Physical evaluation revealed increased swelling of the right forearm and an ultrasound of the right forearm demonstrated a RAP of the right radial artery measuring up to 3.9x1.9 cm with 3.4 mm neck. Tight compression bandage was further prolonged following ultrasound compression with vascular probe which failed to alleviate her complaints. Following failure of conservative therapy and in lieu of her symptoms, surgical exploration, clot removal and successful repair was done.

Abstract

The transradial access for diagnostic and therapeutic purpose is becoming increasingly popular, mainly because of its lack of complications. Radial artery pseudoaneurysm (RAP) is an extremely rare complication, so many of its clinical features are unknown and treatment is not systematic. Therapeutic options are conservative management, ultrasound-guided compression, thrombin injection and surgical intervention. Here, we report a 43-year old female who underwent transradial percutaneous angioplasty of left anterior descending artery. During cannulation of her radial artery, multiple puncture attempts were done. Upon removal of the transra¬dial compression band (TR Band), forearm ecchymosis and small hematoma were noted with mild pain. Tight compression bandage was applied but on the following day, she had complaints of increasing right forearm pain and tenderness. Physical evaluation revealed increased swelling of the right forearm and an ultrasound of the right forearm demonstrated a RAP of the right radial artery measuring up to 3.9x1.9 cm with 3.4 mm neck. Tight compression bandage was further prolonged following ultrasound compression with vascular probe which failed to alleviate her complaints. Following failure of conservative therapy and in lieu of her symptoms, surgical exploration, clot removal and successful repair was done.

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Keywords

radial artery pseudoaneurysm, surgery, transradial intervention, thrombin injection, ultrasound compression

About this article
Title

Radial artery pseudoaneurysm (RAP) following transradial intervention — an extremely rare complication successfully managed by surgery: case report

Journal

Acta Angiologica

Issue

Vol 23, No 4 (2017)

Article type

Case report

Pages

165-169

Published online

2017-12-28

Page views

1059

Article views/downloads

1761

DOI

10.5603/AA.2017.0018

Bibliographic record

Acta Angiologica 2017;23(4):165-169.

Keywords

radial artery pseudoaneurysm
surgery
transradial intervention
thrombin injection
ultrasound compression

Authors

Santosh Kumar Sinha
Mukesh Jitendra Jha
Vikas Mishra
Mahmadula Razi
Anupam Mahrotra
Mohammad Asif
Nasar Abdali
Vikas Chaturvedi
Lokendra Rekwal

References (12)
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