Author + information
- Received October 20, 2011
- Accepted October 28, 2011
- Published online March 1, 2012.
- Iñaki Villanueva-Benito, MD⁎,⁎ ( )(, )
- Itziar Solla-Ruiz, MD⁎,
- Raquel Rodriguez-Calveiro, MD†,
- Jose Luis Maciñeiras-Montero, MD†,
- Carlos Manuel Rodriguez-Paz, MD§ and
- Alberto Ortiz-Saez, MD‡
- ↵⁎Reprint requests and correspondence:
Dr. Iñaki Villanueva-Benito, C/Donibane-Garazi n,°4, 3°C 20019, San Sebastian, Guipuzcoa Cardiology Department, Hospital Donostia, San Sebastian, Guipúzcoa, Osakidetza, Spain
Transradial approach has gained progressive acceptance because it has been shown to have fewer hemorrhagic and vascular-related complications than the femoral approach does for diagnostic and therapeutic percutaneous coronary artery procedures. However, transradial access is not free of complications (1). A 43-year-old man was admitted with a non–ST-segment elevation acute coronary syndrome. A transradial coronary angiography was performed, followed by a drug-eluting stent implantation in the proximal descendent artery. Twenty-four hours after the procedure, he experienced an intense, continuous chest pain in his right upper hemi-thorax that irradiated to the right forearm, without electrocardiographic changes or elevated markers of myocardial damage, and required a high dose of analgesia. A computed tomogram was performed, revealing a subclavian artery pseudoaneurysm that compressed the brachial plexus (Figs. 1A to 1D). A few days later, an endovascular covered self-expanding stent was successfully placed, excluding the pseudoaneurysm (Figs. 1E to 1H). Chest pain disappeared, and the patient was discharged uneventfully.
Subclavian artery pseudoaneurysm is a well-described complication as an inadvertent arterial puncture following central venous catheterization (2). There are a few reported cases of subclavian artery dissection complicating mammary artery graft catheterization performed via the transfemoral approach (3), but to our knowledge, this is the first description of a subclavian pseudoaneurysm complicating a transradial artery cardiac catheterization.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received October 20, 2011.
- Accepted October 28, 2011.
- American College of Cardiology Foundation