Radial Artery Pseudoaneurysm

J Hand Surg Am. 2017 Apr;42(4):295.e1-295.e6. doi: 10.1016/j.jhsa.2017.01.024. Epub 2017 Mar 1.

Abstract

Purpose: To review the causes, clinical course, and management of patients with catheter-associated radial artery pseudoaneurysm (PSA).

Methods: We reviewed all patients diagnosed with radial artery PSA resulting from arterial line placement or radial artery access for cardiac procedures from 2010 to 2015.

Results: We identified 11 cases: 5 caused by arterial lines and 6 by cardiac procedures. The diagnosis was confirmed by duplex ultrasound in all cases; PSA size ranged from less than 1 cm to 5 cm in diameter. Spontaneous thrombosis (over a mean of 27 days) occurred in 4 patients; each PSA was smaller than 3 cm. Surgery was performed in 7 patients with excision of the stalk and repair of the artery as the most common procedure. Only one case was performed emergently for acute carpal tunnel syndrome. Complications occurring owing to either the PSA or the treatment were recorded in 5 patients.

Conclusions: Spontaneous thrombosis may occur in smaller lesions over a few weeks. When required, surgery to evacuate the hematoma and repair the artery was effective in all cases.

Type of study/level of evidence: Therapeutic IV.

Keywords: Radial artery; catheter-associated pseudoaneurysm; pseudoaneurysm.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / etiology
  • Aneurysm, False / surgery*
  • Aneurysm, False / therapy
  • Catheterization, Peripheral / adverse effects*
  • Computed Tomography Angiography
  • Female
  • Hematoma / diagnostic imaging
  • Hematoma / etiology
  • Hematoma / therapy
  • Humans
  • Male
  • Middle Aged
  • Radial Artery / diagnostic imaging
  • Radial Artery / injuries
  • Radial Artery / surgery*
  • Retrospective Studies
  • Thrombosis / diagnostic imaging
  • Thrombosis / etiology
  • Thrombosis / therapy
  • Ultrasonography