Unusual complication of radial artery cannulation

Abstract

Currently, radial artery cannulation is the preferred method for continuous hemodynamic monitoring in critically ill patients. Reported complications of radial artery cannulation include infection, digital gangrene, thrombosis, pseudoaneurysm, skin necrosis and median nerve palsy. Radial artery catheter fracture is a very rare complication. A review of the English language literature revealed only one reported case. We present an additional case of spontaneous radial artery catheter fracture.Key Words: Catheter complications; Catheter fracture; Radial artery cannulation Complication rare de la canulation artérielle radialeLa canulation artérielle radiale est à l'heure actuelle le meilleur moyen de surveillance continue de l'hémodynamie chez les patients gravement atteints. Parmi les complications signalées, mentionnons les infections, la gangrène des doigts, les thromboses, les pseudo-anévrismes, la nécrose de la peau et la paralysie du nerf médian. Toutefois, la cassure du cathéter artériel radial s'avère une complication très rare. Un examen de la documentation en anglais a permis de relever un seul cas déclaré. Il sera question ici d'un autre cas de cassure spontanée du cathéter artériel.

Retained radial artery catheter fragment

“…Following this incident, a session was organized for the intensive care unit nurses to reinforce the care and attention to detail necessary while removing sutures from invasive lines. Another interesting feature of this case was the proximal migration of the retained catheter fragment, although distal migration of the retained fragment has been reported in the literature, there are no reports of proximal migration [ 7 ] This proximal fragment migration was one of the reasons why the bedside exploration of the radial artery was unsuccessful, the other factor being the unavailability of ultrasound at the time of the procedure. The operative removal in the operating theatre was straightforward and uneventful, although it does represent an additional procedure that the patient would not otherwise have been subjected to.…”

Fractura intravascular de un catéter arterial: una complicación poco común pero real

“…Se prefiere la canulación de la arteria radial [5] debido a la presencia de circulación colateral desde la arteria cubital, lo que reduce el riesgo de lesión isquémica. Sin embargo, el acceso radial se asocia con complicaciones como oclusión de la arteria, sepsis, infección local, hematoma, seudoaneurisma o hemorragia [6].…”