Management of iatrogenic radial artery perforation.
The aim of this study was to evaluate a new protocol allowing coronary angiography to be performed transradially in spite of the occurrence of iatrogenic radial artery perforation during catheterization. Nine patients with iatrogenic radial artery perforation were managed conservatively by inserting a long arterial sheath in the damaged radial artery up to the brachial artery, after which the diagnostic and/or interventional procedures that had motivated transradial catheterization were completed via the protected radial artery. Radial angiography performed immediately thereafter showed no extravasation, and no major vascular complications developed during follow-up. The day after the procedure, two patients had asymptomatic radial occlusion, but the other seven patients had normal radial pulses and reversed Allen test responses showing normal perfusion. A conservative management technique, installation of a long arterial sheath not only promotes resolution of iatrogenic radial artery perforation but also allows the procedures motivating catheterization to be completed transradially.
Calviño-Santos
Ramón Antonio
RA
Department of Cardiology, Hospital Juan Canalejo, A Coruña, Spain. calvi@canalejo.org
Vázquez-Rodríguez
José Manuel
JM
Salgado-Fernández
Jorge
J
Vázquez-González
Nicolás
N
Pérez-Fernández
Ruth
R
Vázquez-Rey
Eugenia
E
Castro-Beiras
Alfonso
A
D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D016602:Needlestick Injuries / Q000628:therapy*; D019919:Prosthesis Implantation / Q000379:methods*; D017534:Radial Artery; D016896:Treatment Outcome