title: Acute hand ischemia after radial intervention in patient with CREST-associated pulmonary hypertension: successful treatment with manual thromboaspiration.
abstract: We describe the case of a 60-year-old woman with CREST (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) associated pulmonary hypertension undergoing transradial coronary angiography. The day after the procedure, the patient complained of severe symptoms and signs of acute hand ischemia. Urgent right upper extremity angiography showed the lack of ulnar palmar arch and a severe narrowed radial artery with endoluminal filling defect. The patient was successfully treated with manual thromboaspiration leading to a complete flow restoration and symptom relief. This case shows that radial occlusion, one of the most common and usually asymptomatic complications following transradial cardiac catheterization, may cause severe hand ischemia in patients with small-vessel inflammatory disease.
authors: Institute of Cardiology, Bologna University, St Orsola/Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy. vbneviotaglieri@hotmail.it
authors: Nevio
authors: N
authors: Taglieri
authors: Nazzareno
authors: N
authors: Galiè
authors: Antonio
authors: A
authors: Marzocchi
mesh_terms: D000208:Acute Disease; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000150:complications; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D015154:Esophageal Motility Disorders / Q000150:complications; D005260:Female; D006225:Hand / Q000098:blood supply*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000628:therapy*; D007049:Iatrogenic Disease; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology*; D008875:Middle Aged; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D011859:Radiography; D011928:Raynaud Disease / Q000150:complications; D013684:Telangiectasis / Q000150:complications*; D017131:Thrombectomy / Q000009:adverse effects* / Q000379:methods