A Dramatic Complication: Iatrogenic Radial Artery Perforation

A 75 years old woman patient was admitted with a non-ST-segment elevation myocardial infarction. After insertion of a 6F radial sheath into the right radial artery and intra-arterial administration of heparin plus verapamil, 0.035 inch guidewire and catheter could not be advanced under fluoroscopic guidance. Immediately afterwards, radial angiography was performed, which displayed a radial artery per- foration with significant contrast extravasation. Held in place for 20 minutes with application of external compression with a sphygmo- manometer cuff at the level of systolic blood pressure. We used balloon assisted tracking and guide catheter tamponade tecnique to complete the angioplasty procedure via the radial artery and successfully seal the radial artery perforation. We describe a case where this technique was used to both treat radial artery perforation and to complete the angioplasty via the radial approach.