Radial catheterization complications

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Radial artery cathetarization Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

Overview

Complications of Radial Catheterization

  1. Local pain and swelling
  2. Thrombosis
  3. Embolization[1]
  4. Hematoma leading to compartment syndrome[2]
  5. Infection[3]
  6. Pseudoaneurysm[4]
  7. Blood loss[5]
  8. Vasospasm
  9. Limb ischemia
  10. Arteriovenous fistula
  11. Cerebral embolization[6]
  12. Peripheral neuropathy

Optical coherence tomography (OCT) has been used by Yonetsu et al to define the damage to the radial artery in 73 arteries of 69 patients [7]. 32% of patients developed intimal tears and 16% of patients developed medial dissections. Repeat catheterization was associated with increased fibro-intimal hyperplasia. Cardiac catheterization via the radial approach may render the radial artery unsuitable for coronary artery bypass grafting. There can be a loss of pulse in about 4% of cases. Use of smaller guide catheters and sheathless guides may potentially reduce the risk of these complications.

References

  1. Downs JB, Rackstein AD, Klein EF, Hawkins IF (1973). "Hazards of radial-artery catheterization". Anesthesiology. 38 (3): 283–6. PMID 4698148.
  2. Araki T, Itaya H, Yamamoto M (2010). "Acute compartment syndrome of the forearm that occurred after transradial intervention and was not caused by bleeding or hematoma formation". Catheter Cardiovasc Interv. 75 (3): 362–5. doi:10.1002/ccd.22282. PMID 19821498.
  3. Mimoz O, Pieroni L, Lawrence C, Edouard A, Costa Y, Samii K; et al. (1996). "Prospective, randomized trial of two antiseptic solutions for prevention of central venous or arterial catheter colonization and infection in intensive care unit patients". Crit Care Med. 24 (11): 1818–23. PMID 8917031.
  4. Inan MB, Acikgoz B, Yazicioglu L, Kaya B, Ozyurda U (2011). "A rare complication of radial artery catheterization". Vascular. 19 (3): 167–9. doi:10.1258/vasc.2010.cr0238. PMID 21652670.
  5. Smoller BR, Kruskall MS (1986). "Phlebotomy for diagnostic laboratory tests in adults. Pattern of use and effect on transfusion requirements". N Engl J Med. 314 (19): 1233–5. doi:10.1056/NEJM198605083141906. PMID 3702919.
  6. Lund C, Nes RB, Ugelstad TP, Due-Tønnessen P, Andersen R, Hol PK; et al. (2005). "Cerebral emboli during left heart catheterization may cause acute brain injury". Eur Heart J. 26 (13): 1269–75. doi:10.1093/eurheartj/ehi148. PMID 15716287.
  7. Yonetsu T, Kakuta T, Lee T, et al. Assessment of acute injuries and chronic intimal thickening of the radial artery after transradial coronary intervention by optical coherence tomography. Eur Heart J. 2010;Epub ahead of print.

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