Severe ischemia after radial artery catheterization: A literature review of published cases

Introduction: Severe ischemia is a rare complication of radial artery catheterization (RAC). This study aims to summarize risk factors of RAC-elicited severe hand ischemia, preventive, and therapeutic management. Methods: Literature search was conducted in eight electronic English and Chinese databa...

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Bibliographic Details
Published in:The journal of vascular access 2024-05, Vol.25 (3), p.767-773
Main Authors: Ying, Ying, Lin, Xian-ju, Chen, Min-juan, Cao, Yan, Yao, Yun-tai
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Amputation, Surgical
Catheterization, Peripheral - adverse effects
Child
Child, Preschool
Female
Hand - blood supply
Humans
Infant
Infant, Newborn
Ischemia - etiology
Ischemia - physiopathology
Male
Middle Aged
Radial Artery - surgery
Regional Blood Flow
Risk Factors
Severity of Illness Index
Treatment Outcome
Young Adult
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Summary:Introduction: Severe ischemia is a rare complication of radial artery catheterization (RAC). This study aims to summarize risk factors of RAC-elicited severe hand ischemia, preventive, and therapeutic management. Methods: Literature search was conducted in eight electronic English and Chinese databases to identify relevant published cases. Data of interest was extracted and analyzed. Results: Database search identified 28 articles reporting cases of 57 patients developing hand ischemia following RAC. Patients aged between 1 day and 88 years. The indications for RAC included surgery, shock, cardiac arrest, and Neonatal Intensive Care Unit (NICU) admission. Identified risk factors included pre-existing vascular diseases, hypotension, arterial anatomical abnormality or small diameter, vasoconstrictors, and catheter-related problems. Totally, 18 patients complained pain; 32 developed discoloration; 19 pulselessness; 3 paresthesia; 13 swolleness and 19 coldness. Eventually, 30 patients recovered well, but 20 patients unfortunately underwent digital amputation and three patients deceased due to non-RAC-related causes. Conclusion: Severe hand ischemia following RAC is a rare complication, with the reported incidence of approximately 0.09%. There is no definite predictor for RAC-related hand ischemia, but patients with risk factors are prone to the occurrence of hand ischemia. It’s vital to initiate early recognition and proactive strategies for a best practice RAC insertion.
ISSN:1129-7298
1724-6032
1724-6032
DOI:10.1177/11297298221101784