Radial artery mycotic pseudoaneurysm in a haemophiliac: a potentially fatal complication of arterial catheterization

Harkin, Denis W.; Connolly, David; Chandrasekar, R.; Anderson, Marion C.; Blair, Paul; Hood, John; D'Sa, A.A.B. Barros

doi:10.1046/j.1365-2516.2002.00664.x

Cited by 12 publications

(7 citation statements)

References 14 publications

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“…Despite recommendations to use the radial artery as the first cannulation site in neonates and children, there are reports of serious complications in adult patients associated with indwelling radial artery catheters (19–21). Sellden et al.…”

Section: Discussionmentioning

confidence: 99%

Catheterization of the radial or brachial artery in neonates and infants

Schindler¹,

Kowald²,

Suess³

et al. 2005

Pediatric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Catheterization of the radial or brachial artery in neonates and infants

Schindler¹,

Kowald²,

Suess³

et al. 2005

Pediatric Anesthesia

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“…Fields et al [5] reported the case of an infant who developed a radial artery pseudoaneurysm following arterial puncture and was subsequently diagnosed with haemophilia. Harkin et al [6] reported the case of radial artery pseudoaneurysm formation in a haemophiliac patient, which developed after radial artery cannulation.…”

Section: Handmentioning

confidence: 99%

Pseudoaneurysms in haemophilia

Rodríguez-Merchán

2013

Blood Coagulation &Amp; Fibrinolysis

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The incidence of bleeding as a result of a pseudoaneurysm in haemophilia is very low. The diagnosis should be suspected if the patient has a history of arterial trauma. Pseudoaneurysms can appear anywhere where trauma occurs. This can include arterial access for catheterization, blunt trauma or penetrating trauma. The diagnosis should be confirmed using Duplex ultrasonography, computed tomography (CT) angiogram or conventional angiogram. Many options exist for the treatment of pseudoaneurysms. Although surgery was the gold standard treatment in the past (surgical ligation with or without distal bypass), several less invasive treatment options are popular today. They include covered stent, ultrasound probe compression and ultrasound-guided thrombin injection. So far, only 14 pseudoaneurysms have been reported in patients with haemophilia: nine were located in the musculoskeletal system (four in the hand, four in the knee, one in the ankle), whereas five were non-musculoskeletal. Early diagnosis and treatment of this complication is vital. Endovascular treatment offers a minimally invasive treatment option. If arterial embolization fails to solve the pseudoaneurysm, open vascular surgery with surgical ligation with or without distal bypass should be performed. Whatever the procedure, a correct surgical haemostasis must be achieved by the infusion of factor concentrate (recombinant or plasma-derived) at the right dose and tranexamic acid. The advent of activated prothrombin complex concentrates and recombinant factor VIII (rFVIIa) has made invasive procedures possible in haemophilia patients with high-titre inhibitors.

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“…Many small postcatheterization pseudoaneurysms tend to spontaneously thrombose over time . However, large pseudoaneurysms which do not thrombose spontaneously, should be treated, because potential complications of RAP may be nearby venous compression, thromboembolism and rupture with significant bleeding requiring urgent surgery . Until recently, the standard technique of treatment has been surgical repair including radial artery ligation, patch angioplasty using vein segment, RAP ligation and excision with end‐to‐end anastomosis .…”

Section: Discussionmentioning

confidence: 99%

New technique for treatment of postcatheterization radial artery pseudoaneurysm

Бабунашвили¹,

Pancholy

Карташов³

2016

Cathet Cardio Intervent

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We report a new technique for treatment of radial artery pseudoaneurysm (RAP) caused by transradial access (TRA) for coronary angiography. Traditional extrinsic compression with radial flow cessation leads to a local milieu likely associated with an increase in probability of radial artery occlusion (RAO). Our technique involves obtaining ipsilateral radial artery access distal to the neck of the RAP followed by a prolonged sheath dwell time covering the neck of the RAP which allows the RAP sac to thrombose and maintains radial artery lumen patency. © 2016 The Authors. Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.

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Radial artery mycotic pseudoaneurysm in a haemophiliac: a potentially fatal complication of arterial catheterization

Abstract: We present a case of radial artery pseudoaneurysm formation in a haemophiliac patient, which developed after radial artery cannulation. Haematologists and anaesthetists should be aware of this potentially fatal condition.

Cited by 12 publications

References 14 publications

Catheterization of the radial or brachial artery in neonates and infants

Catheterization of the radial or brachial artery in neonates and infants

Pseudoaneurysms in haemophilia

New technique for treatment of postcatheterization radial artery pseudoaneurysm

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