Radial artery pseudoaneurysm (RAP) following transradial intervention — an extremely rare complication successfully managed by surgery: case report

Abstract

The transradial access for diagnostic and therapeutic purpose is becoming increasingly popular, mainly because of its lack of complications. Radial artery pseudoaneurysm (RAP) is an extremely rare complication, so many of its clinical features are unknown and treatment is not systematic. Therapeutic options are conservative management, ultrasound-guided compression, thrombin injection and surgical intervention. Here, we report a 43-year old female who underwent transradial percutaneous angioplasty of left anterior descending artery. During cannulation of her radial artery, multiple puncture attempts were done. Upon removal of the transra¬dial compression band (TR Band), forearm ecchymosis and small hematoma were noted with mild pain. Tight compression bandage was applied but on the following day, she had complaints of increasing right forearm pain and tenderness. Physical evaluation revealed increased swelling of the right forearm and an ultrasound of the right forearm demonstrated a RAP of the right radial artery measuring up to 3.9x1.9 cm with 3.4 mm neck. Tight compression bandage was further prolonged following ultrasound compression with vascular probe which failed to alleviate her complaints. Following failure of conservative therapy and in lieu of her symptoms, surgical exploration, clot removal and successful repair was done.