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Management of radial artery perforation complicating coronary intervention: a stepwise approach

Mansour M Sallam1, Mehar Ali, Rashid Al-Sekaiti

  • 1Sultan Qaboos University Hospital, Al-Khod 123, Muscat, Sultanate of Oman. mansoursallam@yahoo.com

Journal of Interventional Cardiology
|May 5, 2011
PubMed

Insights

Radial artery perforation during coronary procedures is rare. This study presents three management strategies, including a novel use of a polytetrafluoroethylene (PTFE) covered stent for severe radial artery perforation.

Area of Science:

  • Cardiovascular Interventions
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • The radial artery approach offers an alternative to femoral access for coronary procedures.
  • While generally safe, iatrogenic radial artery perforation can occur, necessitating effective management strategies.

Observation:

  • Three cases of iatrogenic radial artery perforation were managed using distinct approaches.
  • Initial management involved conservative measures like prolonged catheter positioning and external compression.
  • Failure of conservative methods led to prolonged balloon inflation in one case.

Findings:

  • Conservative management and prolonged balloon inflation were insufficient in one severe perforation case.
  • A polytetrafluoroethylene (PTFE) covered stent was successfully used for complete reconstruction of a radial artery perforation.
  • This represents the first reported use of a PTFE covered stent for this specific complication.

Implications:

  • This study highlights diverse management options for radial artery perforation.
  • The successful use of a PTFE covered stent offers a new therapeutic avenue for complex radial artery injuries.
  • Further research is warranted to establish the long-term efficacy and safety of covered stent use in radial artery perforation.

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