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Complication after Cardiac Catheterization in a Patient with IHD

Veselin Petrov, Veselin Petrov, Desislava Ivanova

Abstract

Introduction: An 86-year-old female patient was being treated for acute myocardial ischaemia by means of catheterization of the right radial artery and insertion of a coronary stent, thus managing the ischaemia. In the next 24 hours, however, a large haematoma of the right forearm occurred, and at the puncture site false aneurysm of the radial artery was formed, in which a big thrombus was located. This lead to swelling, bluish colour, pain and difficulties in the movement of the forearm. At the puncture site a spheric sacciform aneurysm was found with big sidewall thrombus and small residual lumen, through which the blood flowed.

Materials and Methods: The patient was operated on – opening and preparing of the radial artery and clamping of the right radial artery. The aneurysmal sac was opened, thrombectomy was performed and the artery was sutured by 6/0 monofilament suture.

Results: The patient was managed and discharged with stable haemodynamics, very good general condition and pulsations in the right radial artery.

Conclusions: In rare cases after interventional procedures in the arterial system, lesions in vascular wall occur, resulting in the formation of pathological structures – аneurysms at the puncture site. Oftentimes hemorrhages occur, which is inevitable after breaking the integrity of the artery, thus forming large, for the diameter of the vessel, foramen. Metal guide wires, balloons and stents pass through the puncture in order to keep the artery hole open. In elderly patients, the trauma of the vessel is one of the main reasons for developing such a complication.


Keywords

cardiac catheterization, surgery, ischaemia


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