Current concepts| Volume 44, ISSUE 11, P973-979, November 2019

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Complications of Transradial Catheterization and Cannulation

Published:August 21, 2019DOI:
      Transradial catheterization and cannulation are typically well-tolerated procedures, but they are associated with various vascular, infectious, and orthopedic complications. Potential complications include radial artery occlusion, hematoma formation, radial artery laceration, pseudoaneurysm, abscess formation, and compartment syndrome. Hand surgeons are commonly consulted to treat such complications. We review recent evidence available to guide decisions about nonsurgical and surgical interventions to treat and prevent the complications associated with transradial access procedures.

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        • Cauley R.
        • Wu W.W.
        • Doval A.
        • Chaikof E.
        • Ho K.K.L.
        • Iorio M.L.
        Identifying complications and optimizing consultations following transradial arterial access for cardiac procedures.
        Ann Vasc Surg. 2019; 56: 87-96
        • Brueck M.
        • Bandorski D.
        • Kramer W.
        • Wieczorek M.
        • Holtgen R.
        • Tillmanns H.
        A randomized comparison of transradial versus transfemoral approach for coronary angiography and angioplasty.
        JACC Cardiovasc Interv. 2009; 2: 1047-1054
        • Garg K.
        • Howell B.W.
        • Saltzberg S.S.
        • et al.
        Open surgical management of complications from indwelling radial artery catheters.
        J Vasc Surg. 2013; 58: 1325-1330
        • Rashid M.
        • Kwok C.S.
        • Pancholy S.
        • et al.
        Radial artery occlusion after transradial interventions: a systematic review and meta-analysis.
        J Am Heart Assoc. 2016; 5: 1-22
        • Plante S.
        • Cantor W.J.
        • Goldman L.
        • et al.
        Comparison of bivalirudin versus heparin on radial artery occlusion after transradial catheterization.
        Catheter Cardiovasc Interv. 2010; 76: 654-658
        • Brzezinski M.
        • Luisetti T.
        • London M.J.
        Radial artery cannulation: a comprehensive review of recent anatomic and physiologic investigations.
        Anesth Analg. 2009; 109: 1763-1781
        • Hahalis G.N.
        • Leopoulou M.
        • Tsigkas G.
        • et al.
        Multicenter randomized evaluation of high versus standard heparin dose on incident radial arterial occlusion after transradial coronary angiography: the Spirit of Artemis study.
        JACC Cardiovasc Interv. 2018; 11: 2241-2250
        • Dharma S.
        • Kedev S.
        • Patel T.
        • Kiemeneij F.
        • Gilchrist I.C.
        A novel approach to reduce radial artery occlusion after transradial catheterization: postprocedural/prehemostasis intra-arterial nitroglycerin.
        Catheter Cardiovasc Interv. 2015; 85: 818-825
        • Pancholy S.
        • Coppola J.
        • Patel T.
        • Roke-Thomas M.
        Prevention of radial artery occlusion-patent hemostasis evaluation trial (PROPHET study): a randomized comparison of traditional versus patency documented hemostasis after transradial catheterization.
        Catheter Cardiovasc Interv. 2008; 72: 335-340
        • Pancholy S.B.
        • Bernat I.
        • Bertrand O.F.
        • Patel T.M.
        Prevention of radial artery occlusion after transradial catheterization: the PROPHET-II randomized trial.
        JACC Cardiovasc Interv. 2016; 9: 1992-1999
        • Jaradat Z.
        • Basir B.
        • Revtyak G.
        Treatment of radial artery occlusions using balloon angioplasty and localized intra-arterial abciximab.
        J Interv Cardiol. 2014; 27: 217-222
        • Valentine R.J.
        • Modrall J.G.
        • Clagett G.P.
        Hand ischemia after radial artery cannulation.
        J Am Coll Surg. 2005; 201: 18-22
        • Scheer B.
        • Perel A.
        • Pfeiffer U.J.
        Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine.
        Crit Care. 2002; 6: 199-204
        • Jue J.
        • Karam J.A.
        • Mejia A.
        • Shroff A.
        Compartment syndrome of the hand: a rare sequela of transradial cardiac catheterization.
        Tex Heart Inst J. 2017; 44: 73-76
        • 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; 31: 1608-1615
        • Gelberman R.H.
        • Nunley J.A.
        • Koman L.A.
        • et al.
        The results of radial and ulnar arterial repair in the forearm. Experience in three medical centers.
        J Bone Joint Surg Am. 1982; 64: 383-387
        • Schippers S.M.
        • Hajewski C.
        • Glass N.A.
        • Caldwell L.
        single forearm vessel injury in a perfused hand: repair or ligate? A systematic review.
        Iowa Orthop J. 2018; 38: 159
        • Garvin R.P.
        • Ryer E.J.
        • Yoon H.R.
        • et al.
        Ultrasound-guided percutaneous thrombin injection of iatrogenic upper extremity pseudoaneurysms.
        J Vasc Surg. 2014; 59: 1664-1669
        • Swanson E.
        • Freiberg A.
        • Salter D.R.
        Radial artery infections and aneurysms after catheterization.
        J Hand Surg Am. 1990; 15: 166-171
        • Zegri I.
        • Garcia-Touchard A.
        • Cuenca S.
        • Oteo J.F.
        • Fernandez-Diaz J.A.
        • Goicolea J.
        Radial artery pseudoaneurysm following cardiac catheterization: clinical features and nonsurgical treatment results.
        Rev Esp Cardiol (Engl Ed). 2015; 68: 349-351
        • Tosti R.
        • Ozkan S.
        • Schainfeld R.M.
        • Eberlin K.R.
        Radial artery pseudoaneurysm.
        J Hand Surg Am. 2017; 42: 295.e6
        • Kazmers N.H.
        • Fryhofer G.W.
        • Gittings D.
        • Bozentka D.J.
        • Steinberg D.R.
        • Gray B.L.
        Acute deep infections of the upper extremity: the utility of obtaining atypical cultures in the presence of purulence.
        J Hand Surg Am. 2017; 42: 663.e8
        • Tizon-Marcos H.
        • Barbeau G.R.
        Incidence of compartment syndrome of the arm in a large series of transradial approach for coronary procedures.
        J Interv Cardiol. 2008; 21: 380-384

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