Rick Tosti1, Sezai Özkan1, Robert M Schainfeld2, Kyle R Eberlin3. 1. Department of Orthopaedic Surgery, Hand Surgery Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 2. Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 3. Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: keberlin@partners.org.
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.
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.
Authors: Péter Kulyassa; Balázs T Németh; Réka Ehrenberger; Zoltán Ruzsa; Tibor Szük; Péter Fehérvári; Marie Anne Engh; Dávid Becker; Béla Merkely; István F Édes Journal: Front Cardiovasc Med Date: 2022-05-27