Delayed presentation of radial artery pseudoaneurysm secondary to catheter trauma during percutaneous coronary intervention

Heart ◽  
2009 ◽  
Vol 95 (13) ◽  
pp. 1084-1084 ◽  
Author(s):  
P D Williams ◽  
S Eccleshall
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Delayed Presentation ◽  
Artery Pseudoaneurysm ◽  
Percutaneous Coronary

scholarly journals Rare complication of primary percutaneous coronary intervention - perforation of the axillary artery

2019 ◽  
Vol 147 (9-10) ◽  
pp. 615-618
Author(s):  
Dragana Dabovic ◽  
Vladimir Ivanovic ◽  
Anastazija Stojsic-Milosavljevic ◽  
Milovan Petrovic ◽  
Igor Ivanov
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radial Artery ◽  
Primary Percutaneous Coronary Intervention ◽  
Axillary Artery ◽  
Rare Complication ◽  
Coronary Intervention ◽  
Proximal Segment ◽  
Artery Pseudoaneurysm ◽  
Transradial Approach ◽  
Percutaneous Coronary

Introduction. Several arteries can be used as the approach for coronarography or primary percutaneous coronary intervention (pPCI). In patients with acute ST-elevation myocardial infarction (STEMI), when performing pPCI according to the current recommendations, approach artery should be the radial artery. Complications of the transradial approach, such as spasm, asymptomatic occlusion, perforation, nerve damage, arteriovenous fistula, compartment syndrome, and radial artery pseudoaneurysm are described. However, only a few cases describe rare complications of transradial approach such as the perforation of the axillary artery. Case outline. The patient was admitted due to the STEMI. Urgent coronarography found 90% stenosis of the proximal segment of the left anterior descendent branch of the left coronary artery (LAD). During the pPCI, a metal stent was implanted in the proximal segment of the LAD. One hour after the intervention, a hematoma in the right arm was registered with the hemodynamic collapse. Angiography of the left axillary artery showed an extravasation of the contrast. A graft stent was implanted in the area of extravasation. After the intervention, regression of the hematoma was registered. Ten years after the primary intervention, CT coronarography and angiography were performed. The stent in the LAD, as well as in the axillary artery, was without any stenosis. Conclusion. Advanced life expectancy, hypertension, atherosclerosis, anatomical variations, and blood vessel tortuosity contribute to the perforation of the axillary artery, a very rare complication of the radial approach. It is usually treated conservatively. In the case of hemodynamic instability, a stent implantation can be considered, as it was in our case.

Ultrasound guided thrombin injection of pseudoaneurysm of the radial artery after percutaneous coronary intervention

VASA ◽  
2011 ◽  
Vol 40 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Herold ◽  
Brucks ◽  
Boenigk ◽  
Said ◽  
R C. Braun-Dullaeus
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radial Artery ◽  
Surgical Intervention ◽  
Coronary Intervention ◽  
Thrombin Injection ◽  
Ultrasound Guided ◽  
Doppler Measurement ◽  
Artery Pseudoaneurysm ◽  
Percutaneous Coronary ◽  
Feasible Alternative

Thrombin injection is frequently used to occlude iatrogenic pseudoaneurysms in larger vessels, but has never successfully been used in the radial artery location. Here we report the use of this treatment in a patient with radial artery pseudoaneurysm following coronary intervention. After Doppler sonographic visualization of the pseudoaneurysm cavity and its neck, an ultrasound-guided transcutaneous injection of thrombin was carried out. Immediately after the injection, the pseudoaneurysm was completely clotted and Doppler measurement confirmed the stop of blood flow. The result suggests that ultrasound-guided injection of thrombin into a radial artery pseudoaneurysm following coronary intervention is a feasible alternative to surgical intervention.

scholarly journals Distal radial access. Occlussion of the radial artery after percutaneus coronary intervention with radial access

2021 ◽  
Vol 27 (4) ◽  
pp. 80-84
Author(s):  
Darko Kitanoski ◽  
Arman Postadzhiyan ◽  
Vasil Velchev ◽  
Nikolay Stoyanov ◽  
Zhan Zimbakov ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radial Artery ◽  
Pain Syndrome ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Artery Pseudoaneurysm ◽  
Coronary Syndrome ◽  
Radial Access ◽  
Percutaneous Coronary ◽  
European Society Of Cardiology

In 2015, The European Society of Cardiology for Acute Coronary Syndrome recommended that Class I use radial as the preferred access method for any percutaneous coronary intervention regardless of clinical presentation. However, the use of TRA is associated with some complications: radiation artery occlusion (RAO) (The reported incidence of RAO is highly variable in the range of 2-11%, radial arterial spasm, radial arterial perforation, radial artery pseudoaneurysm, arteriovenous fistula, bleeding, nerve damage, and complex regional pain syndrome. Limited data are available regarding the technique of distal radial access, complications, and potential benefits. The purpose of our study is to compare the incidence of radial artery occlusion between distal radial and conventional radial access. The study included 292 patients (who underwent percutaneous coronary intervention)in who is felt pulsations at the site of a puncture of the radial artery. Patients were followed one month after the procedure, with Doppler ultrasonography or access from the same artery. After a month, the occlusion of the radial artery occurred in 8 (5.7%) patients in conventional radial access, there was no occlusion of the radial artery in the distal radial access group. This investigation shows that distal radial access is associated with a lower incidence of occlusion of the radial artery.

scholarly journals Anxiety score as a predictor of radial artery spasm during transradial approach for percutaneous coronary intervention

2018 ◽  
Vol 70 ◽  
pp. S71
Author(s):  
Krishnarpan Chatterjee ◽  
Naveen Garg ◽  
Umamaheshwar K. L ◽  
Roopali Khanna ◽  
Aditya Kapoor ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Anxiety Score ◽  
Transradial Approach ◽  
Percutaneous Coronary

scholarly journals Radial artery access for coronary angiography and percutaneous coronary intervention

BMJ ◽  
2004 ◽  
Vol 329 (7463) ◽  
pp. 443-446 ◽  
Author(s):  
R Andrew Archbold ◽  
Nicholas M Robinson ◽  
Richard J Schilling
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Percutaneous Coronary

scholarly journals Predictive Factors for Access-Site Pain Chronicity after Percutaneous Coronary Intervention via Radial Artery Access

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Liuda Brogiene ◽  
Giedre Baksyte ◽  
Agne Klimaite ◽  
Martynas Paliokas ◽  
Andrius Macas
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Pain Intensity ◽  
Radial Artery ◽  
Predictive Factors ◽  
Coronary Intervention ◽  
Access Site ◽  
Access Methods ◽  
Percutaneous Coronary ◽  
Pain Prevalence ◽  
Strong Opioids

Objectives. The aim of this study is to assess the prevalence and predictive factors for developing chronic access-site (A-S) pain after percutaneous coronary intervention (PCI) via radial artery access. Methods. Data of selected patients (n = 161) who underwent elective PCI were collected prospectively and analysed in 2020. Verbal analogue scale was used to evaluate pain intensity after 12, 24, and 48 h and 3 months after PCI. The univariate logistic regression analysis was used. Results. Pain prevalence decreased from 29% straight after PCI and 54% two hours later to 3.7% following 3 months after procedure. The predictors for A-S pain chronicity are diabetes (OR = 5.77 95% CI (1.07–31.08), p = 0.041 ), hematoma (OR = 6.48, 95% CI (1.06–39.66), p = 0.043 ), A-S hand neuropathy (OR = 19.93 95% CI (1.27–312.32), p = 0.033 ), A-S pain immediately after PCI (OR = 14.60 95% CI (1.63–130.27), p = 0.016 ), after 12 h (OR = 17.2 95% CI (1.60–185.27), p = 0.019 ), 24 h (OR = 48 95% CI (4.87–487), p = 0.01 ), and 48 h (OR = 23.46 95% CI (3.81–144.17), p = 0.001 ), and pain intensity immediately after procedure (OR = 3.30 95% CI (1.65–6.60), p = 0.001 ), after 2 h (OR = 2.56 95% CI (1.15–5.73), p = 0.022 ), after 12 h (OR = 3.02 95% CI (1.70–5.39), p < 0.001 ), after 24 h (OR = 3.58 95% CI (1.90–6.74), p < 0.001 ), and after 48 h (OR = 2.89 95% CI (1.72–4.87), p < 0.001 ). Pain control was performed with Ketoprofen and Ibuprofen as most used NSAIDs. 10 mg of Morphine intravenously was the choice from strong opioids if necessary. Conclusions. The prevalence of chronic A-S pain is 3.7%. Main predictive factors for the A-S pain chronicity are diabetes, hematoma, and persistent pain and pain intensity during 48 h period after PCI.

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