Acute compartment syndrome: A rare but important complication of transradial cardiac catheterization

The transradial approach has become the gold-standard for coronary angiography. It is better tolerated by patients, associated with less bleeding, earlier post-procedure mobilization, and reduced mortality in patients with myocardial infarction. Given the hand's dual arterial supply and extensive collateral circulation, the risk of serious functional injury after radial catheterization is essentially reduced to zero. However, even a small amount of bleeding in the volar compartment can lead to compartment syndrome (CS) and permanent neurovascular injury. The purpose of this paper is to describe our experience with an unusual case of late-onset acute CS following transradial coronary angiography, and to summarize the available literature on this topic. <Learning objective: The transradial approach has become the gold-standard for coronary angiography. However, in rare cases, this approach may be associated with bleeding and acute compartment syndrome. Patients on anticoagulants, and those who have severe atherosclerosis appear to be at increased risk of this complication. The diagnosis relies upon clinician awareness and vigilance, and affected patients require early decompressive fasciotomy to prevent permanent neurovascular injury.>.