Pseudoaneurysm - radial artery

Case contributed by Esteban Calleja Montealegre
Diagnosis certain

Presentation

A patient that had a myocardial infarction and she underwent a right radial catheterization. Hours later she felt her arm swollen, and her doctor wanted to see if there was a hematoma.

Patient Data

Age: 55 years
Gender: Female
ultrasound

There is a saccular formation with a small neck communicating with the right radial artery. At the color Doppler analysis, it shows aliasing at the neck and inside some blood goes in and out from the pseudoaneurysm, giving the typical Yin-yang sign. At the neck, where aliasing is seen, the peak systolic velocity was 300cm/s.

Case Discussion

Arterial injuries after catheterization, with no active bleeding, leave us not many options. If there is a saccular formation next to the artery, it will be a pseudoaneurysm and if it is communication between the artery and a vein, it will be a fistula.

If it's a fistula, most findings will be at the fistula site and above from it. 

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