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Infected radial artery pseudoaneurysms occurring after percutaneous cannulation
P S Falk1, P E Scuderi, R J Sherertz
1Department of Infection Control (Hospital Epidemiology), North Carolina Baptist Hospitals, Winston-Salem.
Chest
|February 1, 1992
Summary
Infected radial artery pseudoaneurysms (RAPAs) are rare complications of arterial lines. Longer catheter duration, older age, and Staphylococcus aureus infection are key risk factors.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Critical Care Medicine
Background:
- Radial artery catheters are commonly used for hemodynamic monitoring in intensive care units (ICUs).
- Complications, though infrequent, can arise from arterial cannulation.
- Infected pseudoaneurysms are a potential, serious adverse event.
Observation:
- Three cases of infected radial artery pseudoaneurysms (RAPAs) associated with arterial lines were identified over ten months in 1988.
- A retrospective review found three additional cases from 1986.
- The overall incidence was 0.048% (6/12,500) between 1983 and 1988.
Findings:
- Five of six RAPAs were linked to Staphylococcus aureus infection.
- Patients developing RAPAs had significantly longer radial artery cannulation durations (12.5 days vs. 4.3 days).
- Affected patients were older (mean 71.6 years) and had prolonged ICU stays (average 51 days).
Implications:
- Advanced age, prolonged catheterization, extended hospitalization, and S. aureus infection are potential risk factors for RAPA.
- Awareness of these risk factors may aid in early detection and prevention.
- This highlights the importance of vigilant monitoring for vascular complications in critically ill patients.