ARYA Atherosclerosis Journal

Percutaneous endovascular exclusion of radial artery pseudoaneurysm

Document Type : Case Report

Authors

Santosh Kumar Sinha 1
Puneet Aggarwal 2
Mahmodullah Razi 2
Awadesh K Sharma 2
Umeshwar Pandey 3
Vinay Krishna 3

1 Associate Professor, Department of Cardiology, LPS Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India

2 Senior Registrar, Department of Cardiology, LPS Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial Medical College Kanpur, Uttar Pradesh, India

3 Professor, Department of Cardiology, LPS Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial Medical College Kanpur, Uttar Pradesh, India

https://doi.org/10.22122/arya.v17i0.2255
Abstract
BACKGROUND: Coronary angiography and intervention through transradial approach is becoming default approach because of infrequent local site complications. Although pseudoaneurysm is a well described complication for femoral access, it is extremely rare in transradial access.CASE REPORT: Our patient was 68-year old female who had presented with pulsatile, painful, and gradually increasing swelling over lower part of right forearm near wrist joint for past 8-weeks following coronary angiography through right radial route. Swelling did not resolve following manual compression. It was diagnosed as pseudoaneurysm arising from right radial artery by duplex ultrasound. It was successfully excluded by deploying 3.5x18mm Graftmaster covered stent (Abott Vascular, USA) through right transbrachial route. Ultrasonography next day revealed partially thrombosed and completely excluded pseudoaneurysm with swelling completely disappearing at 6 weeks with patency maintained at one year.CONCLUSION: With increasing use of transradial access, more cases of radial pseudoaneurysm are likely to surface which can be prevented following a proper haemostatic protocol. To best of our knowledge, it is first ever report of percutaneous endovascular exclusion using covered stent of radial pseudoaneurysm through transbrachial approach.

Keywords

Angiography
False Aneurysm
Radial Artery
Stent
  1. Jolly SS, Yusuf S, Cairns J, Niemela K, Xavier D, Widimsky P, et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): A randomised, parallel group, multicentre trial. Lancet 2011; 377(9775): 1409-20.
  2. Kanei Y, Kwan T, Nakra NC, Liou M, Huang Y, Vales LL, et al. Transradial cardiac catheterization: A review of access site complications. Catheter Cardiovasc Interv 2011; 78(6): 840-6.
  3. Tatli E, Buturak A, Cakar A, Vatan BM, Degirmencioglu A, Agac TM, et al. Unusual vascular complications associated with transradial coronary procedures among 10,324 patients: Case based experience and treatment options. J Interv Cardiol 2015; 28(3): 305-12.
  4. Collins N, Wainstein R, Ward M, Bhagwandeen R, Dzavik V. Pseudoaneurysm after transradial cardiac catheterization: Case series and review of the literature. Catheter Cardiovasc Interv 2012; 80(2): 283-7.
  5. Liou M, Tung F, Kanei Y, Kwan T. Treatment of radial artery pseudoaneurysm using a novel compression device. J Invasive Cardiol 2010; 22(6): 293-5.
  6. Hamid T, Harper L, McDonald J. Radial artery pseudoaneurysm following coronary angiography in two octogenarians. Exp Clin Cardiol 2012; 17(4): 260-2.
  7. Zegri I, Garcia-Touchard A, Cuenca S, Oteo JF, Fernandez-Diaz JA, Goicolea J. Radial artery pseudoaneurysm following cardiac catheterization: Clinical features and nonsurgical treatment results. Rev Esp Cardiol (Engl Ed) 2015; 68(4): 349-51.
  8. Kuma S, Morisaki K, Kodama A, Guntani A, Fukunaga R, Soga Y, et al. Ultrasound-guided percutaneous thrombin injection for post-catheterization pseudoaneurysm. Circ J 2015; 79(6): 1277-81.
  9. Mohan B, Singal S, Bawa AS, Mahindra P, Yamin M. Endovascular management of traumatic pseudoaneurysm: Short & long term outcomes.
  10. J Clin Orthop Trauma 2017; 8(3): 276-80.
  11. Boumezrag M, Ummat B, Reiner J, Venbrux A, Sarin S. Pseudoaneurysm: A rare complication of distal transradial access in the anatomical snuffbox. CVIR Endovasc 2019; 2(1): 21.
  12. Tsiafoutis I, Zografos T, Koutouzis M, Katsivas A. Percutaneous endovascular repair of a radial artery pseudoaneurysm using a covered stent. JACC Cardiovasc Interv 2018; 11(11): e91-e92.
ARYA Atherosclerosis Journal
Volume 17, Issue 1
January and February 2021
Pages 1-4

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