Management of iatrogenic radial artery perforation

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Radiology

Background:

• Transradial catheterization is a common approach for coronary angiography.
• Iatrogenic radial artery perforation is a potential complication during this procedure.
• Managing perforation while completing the intended procedure is clinically important.

Purpose of the Study:

• To evaluate a novel protocol for managing iatrogenic radial artery perforation during transradial coronary angiography.
• To assess the feasibility and safety of completing procedures after perforation using a modified technique.

Main Methods:

• Nine patients experiencing iatrogenic radial artery perforation during transradial catheterization were included.
• A conservative management approach involved inserting a long arterial sheath up to the brachial artery.
• Diagnostic and/or interventional procedures were completed via the protected radial artery.

Main Results:

• The long arterial sheath technique allowed successful completion of transradial procedures in all nine patients.
• Immediate post-procedure angiography showed no extravasation of contrast dye.
• No major vascular complications were observed during follow-up.
• Two patients developed asymptomatic radial artery occlusion, while seven maintained normal radial pulses and perfusion.

Conclusions:

• Conservative management with a long arterial sheath is effective for iatrogenic radial artery perforation.
• This technique facilitates the completion of transradial catheterization procedures.
• It promotes resolution of perforation and maintains adequate radial artery perfusion.