Delayed,Distant Arterial Injury After Brachial Artery Catheterization

The occurrence of iatrogenic arterial injury secondary to catheterization for angiographic studies has been well documented in the literature for over a decade. ^1-4 It has been well established that patients should be carefully evaluated post-catheterization and if absence of the pulse distal to the arteriotomy site is discovered, most should undergo exploration for identification and correction of the problem. Between 0.3 and 24% of patients undergoing brachial artery catheterization have been found to have a diminished or absent radial pulse after the procedure. ⁵ In the vast majority of cases the problem has been solved by local exploration of the arteriotomy site. However, in a small but definite number of cases late thrombotic complications have become manifest, ⁴ and in two cases reported in 1981⁵ and in the case report to follow, thrombotic complications have become manifest months later, secondary to injury well proximal to the ar teriotomy site.