Mycotic aneurysm of the distal radial artery after cardiac catheterisation

BMJ Case Rep. 2021 Jul 22;14(7):e241506. doi: 10.1136/bcr-2020-241506.

Abstract

A mycotic aneurysm of the distal radial artery following access for cardiac catheterisation is a rare complication that has not been described in the literature. We present the case of an 84-year-old man who developed bacteraemia and cellulitis over his left first dorsal webspace 2 days after undergoing cardiac catheterisation through the distal radial artery at the anatomic snuffbox. Ultrasound scanning and CT imaging were concerning for a possible pseudoaneurysm at that location. Once we confirmed that the patient had adequate flow through his hand with angiography and an Allen's test, we explored his left hand and found a mycotic aneurysm of the distal radial artery with surrounding frank purulence. We resected the aneurysm and ligated the artery. Pathology confirmed that this was a mycotic aneurysm. The patient quickly recovered from his infection after this definitive treatment.

Keywords: infections; interventional cardiology.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aneurysm, False* / diagnostic imaging
  • Aneurysm, False* / etiology
  • Aneurysm, Infected* / diagnostic imaging
  • Aneurysm, Infected* / etiology
  • Aneurysm, Infected* / surgery
  • Cardiac Catheterization / adverse effects
  • Hand
  • Humans
  • Male
  • Radial Artery / diagnostic imaging
  • Radial Artery / surgery