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

The radial approach is an elegant alternative to femoral access for diagnostic and interventional coronary procedures; this access site is infrequently associated with vascular complications, although less than the femoral approach. We present our experience in management of iatrogenic radial artery perforation in 3 cases; one case managed conservatively through prolonged guiding catheter positioning proximal to the perforated segment and external compression by sphygmomanometer cuff. The second case required prolonged balloon inflation after failure of conservative management mentioned above. In the third case, the above-mentioned conservative measures and prolonged balloon inflation failed to seal the perforation; complete reconstruction of the perforation was achieved by a polytetrafluoroethylene (PTFE) coronary covered stent. To our knowledge, this is the first case to be managed utilizing this approach. ©2011, Wiley Periodicals, Inc.