Permanent ischemic injury of the hand after radial artery cannulation is rare, but several cases of thromboembolism after the cannulation leading to amputation of affected limb or digits have been reported. A 48-yr-old man undergoing spine surgery showed normal modified Allen's test and had no preoperative vascular disease. We inserted 20-G radial artery catheter for the continuous monitoring of the blood flow and serial blood sampling. There was no specific event during the operation and the catheter was removed immediately after the operation. The signs and symptoms of the circulatory impairment of the radial artery developed four days after the operation and aggravated thereafter. Through the angiographic study, we found the total occlusion of the radial artery and some of its branches. After an emergent surgical exploration of the radial artery for removal of the thrombus and vein graft for the defect of the artery on the 8th postoperative day, the ischemic signs and symptoms disappeared and the radial pulse was restored.
Catheterization, Peripheral/*adverse effects ; Embolectomy ; Fingers/*blood supply/radiography ; Hand/*blood supply/radiography ; Human ; Male ; Middle Age ; Peripheral Vascular Diseases/etiology/*surgery ; Radial Artery/*abnormalities/surgery ; Thromboembolism/etiology/*surgery ; Treatment Outcome

OBJECTIVETo assess the efficacy and safety of two arterial closure devices, Angioseal and Perclose, in patients undergoing coronary angiography and invasive interventions.

METHODSFrom January 2001 to April 2011, 997 inpatients underwent coronary angiography and interventions with arterial closure using Perclose (486 cases) or Angioseal (511 cases). The time to ambulation and hemostasis, major vascular complications and deployment success rate with the two devices were compared.

RESULTSThe time to hemostasis was significantly shorter in Angioseal group than in Perclose group (3∓0.9 min vs 10.8∓4.8 min, P<0.001), but the time to ambulation was comparable between the two groups (6.4∓1.2 h vs 6.3∓0.7 h, P>0.05). The incidences of vascular complications showed no significant differences between the two groups (4.5% vs 3.7%, P>0.05), and none of the cases in either group developed femoral artery thrombosis or low limb embolism following the procedures. The deployment success rate was comparable between the two groups (97.8% vss 98.6%, P>0.05), and deployment failure was associated mainly with mishandling and design defect of the devices.

CONCLUSIONSAngioseal and Perclose are both effective and safe for arterial closure with reduced hemostasis and ambulation time and low incidences of vascular complications. Angioseal appears to have better performance than Perclose in shortening the hemostasis time and is easier to handle.

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; China ; Coronary Angiography ; adverse effects ; Coronary Disease ; diagnostic imaging ; therapy ; Female ; Femoral Artery ; surgery ; Hemostatic Techniques ; instrumentation ; Humans ; Male ; Middle Aged ; Peripheral Vascular Diseases ; etiology ; Retrospective Studies