False aneurysm of the radial artery


This case demonstrates a radial artery aneurysm following multiple attempts at radial arterial line insertion in the medical high dependency unit. Given the traumatic nature it was felt that this was almost certainly a false aneurysm although several features such as the wide neck and thrombus within are more in keeping with a true aneurysm. 

The standard initial treatment for small peripheral arterial false aneurysms is ultrasound guided thrombin injection however, given the wide neck and overlying erythema/cellulitis it was treated surgically by tying off the vessel, as the risk of graft infection and peripheral embolization was deemed too great. In theater the radial artery was clipped for 10 minutes before tying off to ensure that perfusion by the ulnar artery was adequate.