Sterile inflammation associated with transradial catheterization and hydrophilic sheaths.
In 1999, we noted the development of inflammation and/or abscesses at the site of radial access in a group of patients. Over a 3-year period, we noted this inflammation in 33 patients out of 2,038 (1.6%) who had catheterization via the radial approach. The radial abscesses occurred in 30 patients out of 1,063 (2.8%) in whom we could confirm the use of a hydrophilic-coated sheath, but in no patient for whom we can document that an uncoated sheath was used. No infectious agent could be implicated, and the time course for the development of the abscess, typically 2 to 3 weeks, seemed long for a bacterial infection. Later patients had biopsies, and granulomatous reactions were seen in most. Additionally, a few of the biopsies showed an amorphous extravascular substance consistent with the catheter coating. All patients had good long-term outcomes.
Kozak
Mark
M
Division of Cardiology, Milton S. Hershey Medical Center, Penn State University College of Medicine, Hershey, Pennsylvania 17033, USA. mkozak@psu.edu
Adams
David R
DR
Ioffreda
Michael D
MD
Nickolaus
Michelle J
MJ
Seery
Thomas J
TJ
Chambers
Charles E
CE
Ettinger
Steven M
SM
McNulty
Patrick H
PH
Gilchrist
Ian C
IC
D000038:Abscess / Q000175:diagnosis / Q000209:etiology; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible / Q000009:adverse effects; D004869:Equipment Safety / Q000295:instrumentation; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000209:etiology; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology*; D017534:Radial Artery / Q000601:surgery*; D013242:Sterilization / Q000295:instrumentation*; D017211:Treatment Failure
D020099:Coated Materials, Biocompatible