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Radial Artery Pseudoaneurysm
Rick Tosti, MD¹; Sezai Ozkan, MD¹; Kyle R Eberlin, MD^1,2
1Harvard Medical School, Boston, MA, 2Massachusetts General Hospital, Massachusetts General Hospital

Introduction: The radial artery has been increasingly utilized for vascular access during cardiac catheterization and arterial line monitoring. As a result, hand surgeons may become involved in the management of vascular complications. However, the management of complications has not been well studied and appears to stem from experience with femoral artery pseudoaneurysm despite the anatomic differences in the upper extremity. The purpose of this study was to determine the causes, natural history, and management of patients with catheter associated radial artery pseudoaneurysm.
Methods: We reviewed all patients diagnosed with radial artery pseudoaneurysm resulting from arterial line placement or radial artery access for cardiac procedures from 2010 – 2015.
Results: We identified 11 cases – 5 caused by arterial lines and 6 caused by cardiac procedures. The diagnosis was confirmed by duplex ultrasound in all cases; the size ranged from <1cm to 5cm. Spontaneous thrombosis (over a mean of 27 days) occurred in 4 cases, all of which were smaller than 3cm. Surgery was performed in 6 cases with excision of the stalk and repair of the artery as the most common procedure; none required a vein graft. Only one case was performed emergently for acute carpal tunnel syndrome. Complications occurring either from the disease or the injury occurred in 5 cases.
Conclusion: Spontaneous thrombosis of radial artery pseudoaneurysm may occur in smaller lesions over a few weeks. Surgery to evacuate the hematoma and repair the artery was effective in most cases.

Level of evidence: Prognostic IV

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Back to 2017 Scientific Program ePosters