Radial Artery Pseudoaneurysm With Individualized Non-Operative Management: A 4-Case Series.
Jun Kiat Ho, Zehao Tan, Alexander Sheng Ming Tan et al.
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Case in brief
Four patients developed iatrogenic radial artery pseudoaneurysms after arterial access for blood pressure monitoring or coronary angiography. Management was tailored to hand circulation and pseudoaneurysm anatomy. Ultrasound-guided compression successfully thrombosed one pseudoaneurysm; ultrasound-guided thrombin injection treated two, with one requiring repeat injection after recanalization. In the fourth patient, a large, flat pseudoaneurysm was unsuitable for direct thrombin injection. Balloon-assisted injection was unsuccessful, and a covered stent excluded the pseudoaneurysm.
What made this case unusual
The series illustrates how varied anatomy and clinical circumstances shaped non-operative management, including a large, flat pseudoaneurysm that could not be treated with direct thrombin injection and ultimately required covered-stent exclusion after balloon-assisted injection failed.
Diagnostic / clinical pearl
For radial artery pseudoaneurysm, treatment choice may depend on collateral hand circulation and lesion anatomy; compression, thrombin injection, and endovascular approaches were used in these cases.
Why it matters
The authors note that evidence is limited and further studies are needed to clarify outcomes and establish a standardized treatment algorithm.