Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202102122
Jornal Vascular Brasileiro
Relato de Caso

Prolonged Doppler US-guided pneumatic compression of a radial artery pseudoaneurysm after percutaneous coronary intervention: a simple and effective solution for a rare and challenging problem

Compressão pneumática prolongada e guiada por ultrassom de um pseudoaneurisma da artéria radial após intervenção coronariana percutânea: solução simples e eficaz para um problema raro e desafiador

Marcos Danillo Oliveira; Pedro Perillo; Lélio Lemos Neto; Adriano Caixeta

Downloads: 0
Views: 611

Abstract

Transradial access is associated with fewer access site-related complications, earlier patient mobilization, and greater postprocedural comfort. Pseudoaneurysms are an extremely rare complication after transradial procedures and the radial artery itself is the most atypical arterial site of occurrence. We report a case in which a non-surgical, non-invasive, simple, and effective solution (prolonged pneumatic compression) was used to manage a radial artery pseudoaneurysm, a very rare and challenging complication of transradial procedures.

Supplementary material:

Video 1
Video 2 

Keywords

transradial access, complications, pseudoaneurysm, management, pneumatic compression

Resumo

O acesso arterial transradial está associado a menos complicações relacionadas ao sítio de punção, com deambulação precoce do paciente e maior conforto pós-procedimento. O pseudoaneurisma é uma complicação extremamente rara após procedimentos transradiais, sendo a artéria radial, por si só, o sítio mais incomum para tal ocorrência. Relata-se um caso de um pseudoaneurisma de artéria radial, uma complicação rara e desafiadora, resolvido com êxito e de maneira simples, não invasiva e não cirúrgica (compressão pneumática prolongada).

Material suplementar: 

Vídeo 1
Vídeo 2

Palavras-chave

acesso arterial transradial, complicações, pseudoaneurisma, manejo, compressão pneumática

Referências

1 Corcos T. Distal radial access for coronary angiography and percutaneous coronary intervention: a state-of-the-art review. Catheter Cardiovasc Interv. 2018;93(4):639-44. PMid:30536709.

2 Oliveira MD, Navarro EC, Kiemeneij F. Distal transradial access as default approach for coronary angiography and interventions. Cardiovasc Diagn Ther. 2019;9(5):513-9. http://dx.doi.org/10.21037/cdt.2019.09.06. PMid:31737522.

3 Oliveira MD, Caixeta A. Distal Transradial Access (dTRA) for coronary angiography and interventions: a quality improvement step forward? J Invasive Cardiol. 2020;32(9):E238-9. PMid:32865510.

4 Oliveira MD, Navarro EC, Caixeta A. Distal transradial access for post-CABG coronary and surgical grafts angiography and interventions. Indian Heart J. 2021;73(4):440-5. http://dx.doi.org/10.1016/j.ihj.2021.06.005. PMid:34474755.

5 Oliveira MD, Caixeta A. Distal transradial access for primary PCI in ST-segment elevation myocardial infarction. JACC Cardiovasc Interv. 2022;15(7):794-5. http://dx.doi.org/10.1016/j.jcin.2022.02.021. PMid:35393113.

6 Oliveira MD, Navarro EC, Caixeta A. Distal transradial access for coronary procedures: a prospective cohort of 3,683 all-comers patients from the DISTRACTION registry. Cardiovasc Diagn Ther. 2022;12(2):208-19. http://dx.doi.org/10.21037/cdt-21-542. PMid:35433348.

7 Oliveira MD, Barros TR, Caixeta A. Spontaneously sealed forearm radial artery perforation during a left distal transradial coronary intervention. J Invasive Cardiol. 2020;32(11):E303-4. PMid:33130601.

8 Tatli E, Buturak A, Cakar A, 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. http://dx.doi.org/10.1111/joic.12206. PMid:25989895.

9 Llácer Pérez M, González Jiménez JM, Jiménez Ruiz A. Pseudoaneurysm in the radial artery after catheterization. Rev Esp Anestesiol Reanim. 2006;53(2):119-21. PMid:16553346.

10 Alerhand S, Apakama D, Nevel A, Nelson BP. Radial artery pseudoaneurysm diagnosed by point-of-care ultrasound five days after transradial catheterization: a case report. World J Emerg Med. 2018;9(3):223-6. http://dx.doi.org/10.5847/wjem.j.1920-8642.2018.03.010. PMid:29796148.

11 Hamid T, Harper L, McDonald J. Radial artery pseudoaneurysm following coronary angiography in two octogenarians. Exp Clin Cardiol. 2012;17(4):260-2. PMid:23592950.

12 Paxiuta J, Lobao MJ, Carvalho L. Radial artery pseudoaneurysm: rare complication of a frequent procedure. BMJ Case Rep. 2017;2017:bcr2016218313. http://dx.doi.org/10.1136/bcr-2016-218313. PMid:28073876.

13 Komorowska-Timek E, Teruya TH, Abou-Zamzam Jr AM, Papa D, Ballard JL. Treatment of radial and ulnar artery pseudoaneurysms using percutaneous thrombin injection. J Hand Surg Am. 2004;29(5):936-42. http://dx.doi.org/10.1016/j.jhsa.2004.05.009. PMid:15465248.

14 Kang SS, Labropoulos N, Mansour MA, et al. Expanded indications for ultrasound-guided thrombin injection of pseudoaneurysms. J Vasc Surg. 2000;31(2):289-98. http://dx.doi.org/10.1016/S0741-5214(00)90160-5. PMid:10664498.

15 Kleczynski P, Rakowski T, Dziewierz A, Jakala J, Dudek D. Ultrasound-guided thrombin injection in the treatment of iatrogenic arterial pseudoaneurysms: single-center experience. J Clin Ultrasound. 2014;42(1):24-6. http://dx.doi.org/10.1002/jcu.22106. PMid:24151057.

16 Bauer P, Koshty A, Hamm CW, Gündüz D. Ultrasound guided percutaneous thrombin injection in a radial artery pseudoaneurysm following percutaneous coronary intervention. Clin Res Cardiol. 2014;103(12):1022-4. http://dx.doi.org/10.1007/s00392-014-0744-9. PMid:25049050.

17 Provencher MT, Maurer C, Thompson M, Hofmeister E. Operative grafting of a pseudoaneurysm of the radial artery after a pediatric both-bone forearm fracture. Orthopedics. 2007;30(10):874-5. http://dx.doi.org/10.3928/01477447-20071001-11. PMid:17990416.

18 Oliveira MD, Alves de Sá G, Navarro EC, Caixeta A. Pseudoaneurysm after distal transradial coronary intervention successfully managed by prolonged pneumatic compression: simple solution for a rare and challenging problem. J Invasive Cardiol. 2021;33(10):E836-8. PMid:34609331.

19 Prejean SP, Von Mering G, Ahmed M. Successful treatment of pseudoaneurysm following left distal transradial cardiac catheterization with compression device. Journal for Vascular Ultrasound. 2019;43(2):81-5. http://dx.doi.org/10.1177/1544316719844061.
 


Submetido em:
25/01/2022

Aceito em:
02/06/2022

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
6525a132a9539553ba679c53 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections