Rupture of an infected radial artery false aneurysm

Excerpt

A 67-yr-old male obese smoker was admitted to the intensive care unit with respiratory failure due to exacerbation of chronic obstructive pulmonary disease. A 20G, 5-cm catheter (Seldicath; Plastimed^®, Paris, France) was placed in the right radial artery under aseptic conditions with a single puncture. The catheter was removed on day 5 and its tip sent for routine culture. On day 7, a red, painful, pulsatile mass (Figure A) with purulent discharge appeared at the puncture site. The discharge was sent for culture. Arterial ultrasonography of the lesion revealed a radial artery pseudoaneurysm (Figures B and C). The cultures from both the catheter tip and discharge were positive for methicillin-resistant Staphylococcus aureus. Antibiotic treatment was initiated with teicoplanine on day 9. On day 11, active bleeding at the puncture site developed. A suspected rupture of the pseudoaneurysm was first controlled by manual compression until transfer to the operating room, where the radial artery was ligated and the infected false aneurysm excised. The patient was discharged home three days later.

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