Radial Artery Mycotic Aneurysm

Abstract

A 75-year-old male with diabetes type II and ischemic heart disease presented to the emergency department with a painful mass in the right wrist. He had a history of coronary angiogram performed 26 days earlier. A pulsatile reddened mass was identified on examination. His blood samples showed raised inflammatory parameters. CT scan revealed a distal right radial artery multilobular aneurysm (Panel A). Due to suspected mycotic aneurysm, the patient underwent surgical exploration (B), with ligature of the right radial artery after confirmation of a negative Barbeau test. Positive cultures for Pseudomonas aeruginosa in wound and blood were found.

Compression syndrome of distal peripheral aneurysms of the upper limb

“…In the case of a. radialis, pseudoaneurysms appear more often than true aneurysms and are the result of traumatic or iatrogenic damage to the artery wall. A case of secondary PSA of a. radialis infection is also described (11). This occurs most frequently after invasive blood pressure monitoring and after endovascular interventions.…”

Successful nonoperative management of mycotic radial artery pseudoaneurysm in patient with absent superficial palmar arch

“…1 Whereas Staphylococcus aureus and Salmonella spp are the bacteria most frequently associated with mycotic aneurysm, viridans streptococci are the most common bacteria involved in mycotic aneurysm in patients with concurrent bacterial endocarditis. [3][4][5] Management of mycotic aneurysm has traditionally been resection of the aneurysm and bypass to restore distal flow. DeBakey and Simone in 1946 demonstrated a high rate of limb amputation after mycotic aneurysm resection without revascularization; however, some authors advocate for selective revascularization.…”

“…1 Whereas Staphylococcus aureus and Salmonella spp are the bacteria most frequently associated with mycotic aneurysm, viridans streptococci are the most common bacteria involved in mycotic aneurysm in patients with concurrent bacterial endocarditis. 3 , 4 , 5 …”