Delayed rupture of the radial artery caused by catheter-related sepsis

Arterial catheter-related sepsis was detected in six adult patients during 45 months by prospective surveillance of blood culture results. In two of the patients, infection of the radial artery caused delayed arterial rupture and either hemorrhage or pseudoaneurysm formation despite prompt catheter removal and antibiotic treatment. Features present in these two cases but not in the four uncomplicated cases were infection caused by Staphylococcus aureus and persistence of systemic signs of infection for more than 2 days after catheter removal. A review of the literature showed that these two features have been noted in almost all adult patients previously reported to develop arterial rupture as a complication and not in patients with uncomplicated arterial catheter-related sepsis. Identification of patients at increased risk for this complication may facilitate prompt diagnosis of arterial rupture or exploration and possible resection of an infected segment of artery before rupture occurs.