A Case Report of Radial Artery Pseudoaneurysm After Repeated Radial Puncture for Arterial Blood Gas
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19697 |
Resumo: | Arterial blood gas, with subsequent radial arterial puncture as a simple access point, comprises a ubiquitous medical procedure in the diagnostic workup of patients admitted to the emergency department with dyspnea. Despite being a relatively safe and technically straightforward procedure, due to its considerable use, it is of vital importance to be able to promptly recognize its potential complications. We present the case of a 96-year-old female patient admitted to the emergency department with dyspnea and cough who underwent left radial arterial puncture for arterial blood gas. A total of three puncture attempts were performed until arterial blood was collected. Roughly two weeks upon observation, the patient was readmitted to the emergency department after the insidious appearance of a painful swelling in the left wrist, with progressive worsening since hospital discharge. On physical examination, a painful erythematous pulsatile swelling in the left wrist’s volar aspect was observed, and further point-of-care ultrasound evaluation documented a cysticlike collection, communicating with the radial artery’s lumen, and suggesting the probable diagnosis of iatrogenic radial pseudoaneurysm. The patient was hospitalized and underwent surgical resection of radial pseudoaneurysm, with subsequent arterial repair. Although severe complications from arterial blood gas have a low incidence rate, prompt diagnosis and management are required. Therefore, point-of-care ultrasound, as an additional diagnostic tool, may play a role in minimizing the risk of procedural complications. |
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A Case Report of Radial Artery Pseudoaneurysm After Repeated Radial Puncture for Arterial Blood GasUm Caso Clínico de Pseudoaneurisma da Artéria Radial Após Punção Radial Repetida para Realização de GasometriaAneurysm, False/diagnostic imagingBlood Gas Analysis/adverse effectsEmergency Service, HospitalPoint-of-Care SystemsRadial Artery/diagnostic imagingUltrasonographyArtéria Radial/diagnóstico por imagemFalso Aneurisma/diagnóstico por imagemGasometria/efeitos adversosServiço de Urgência HospitalarSistemas Automatizados de Assistência Junto ao LeitoUltrassonografiaArterial blood gas, with subsequent radial arterial puncture as a simple access point, comprises a ubiquitous medical procedure in the diagnostic workup of patients admitted to the emergency department with dyspnea. Despite being a relatively safe and technically straightforward procedure, due to its considerable use, it is of vital importance to be able to promptly recognize its potential complications. We present the case of a 96-year-old female patient admitted to the emergency department with dyspnea and cough who underwent left radial arterial puncture for arterial blood gas. A total of three puncture attempts were performed until arterial blood was collected. Roughly two weeks upon observation, the patient was readmitted to the emergency department after the insidious appearance of a painful swelling in the left wrist, with progressive worsening since hospital discharge. On physical examination, a painful erythematous pulsatile swelling in the left wrist’s volar aspect was observed, and further point-of-care ultrasound evaluation documented a cysticlike collection, communicating with the radial artery’s lumen, and suggesting the probable diagnosis of iatrogenic radial pseudoaneurysm. The patient was hospitalized and underwent surgical resection of radial pseudoaneurysm, with subsequent arterial repair. Although severe complications from arterial blood gas have a low incidence rate, prompt diagnosis and management are required. Therefore, point-of-care ultrasound, as an additional diagnostic tool, may play a role in minimizing the risk of procedural complications.A gasometria arterial, com consequente punção arterial radial enquanto forma simplificada de acesso, constitui um procedimento médico ubíquo na abordagem diagnóstica dos doentes que recorrem ao serviço de urgência por dispneia. Apesar de se tratar de um procedimento relativamente seguro e tecnicamente simples, dada a sua elevada utilização, é especialmente importante ter a capacidade de reconhecer precocemente as potenciais complicações que dele poderão advir. Apresentamos, em seguida, o caso clínico de uma doente do sexo feminino com 96 anos de idade, que foi admitida no serviço de urgência por dispneia e tosse, tendo sido submetida a punção arterial radial esquerda para realização de gasometria arterial nesse contexto. Um total de três tentativas de punção foram efetuadas até colheita de sangue arterial com sucesso. Aproximadamente duas semanas após este episódio de urgência, a doente foi readmitida no serviço de urgência por aparecimento insidioso de tumefação dolorosa ao nível do punho esquerdo, em agravamento progressivo desde a data de alta hospitalar prévia. No exame físico foi documentada uma tumefação dolorosa, eritematosa e pulsátil na região volar do punho esquerdo, com subsequente avaliação por ecografia clínica à cabeceira-do-doente, documentando uma coleção com aparência cística, comunicando com o lúmen da artéria radial esquerda, enquadrável num diagnóstico provável de pseudoaneurisma radial de etiologia iatrogénica. A doente ficou internada e foi submetida a resseção cirúrgica do pseudoaneurisma radial, com subsequente reparação arterial cirúrgica. Embora as complicações severas da gasometria arterial apresentem baixa incidência, o seu diagnóstico deve ser precoce e a sua abordagem célere. Por conseguinte, o uso da ecografia clínica à cabeceira-do-doente, enquanto complemento diagnóstico prontamente disponível, poderá contribuir para minimizar o risco de complicações.Ordem dos Médicos2023-11-20info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19697Acta Médica Portuguesa; Vol. 37 No. 1 (2024): January; 42-45Acta Médica Portuguesa; Vol. 37 N.º 1 (2024): Janeiro; 42-451646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19697https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19697/15292Direitos de Autor (c) 2023 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessCarvalho, NunoBlaivas, MichaleCaroselli, Costantino2024-01-07T03:00:33Zoai:ojs.www.actamedicaportuguesa.com:article/19697Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T23:19:50.935998Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
A Case Report of Radial Artery Pseudoaneurysm After Repeated Radial Puncture for Arterial Blood Gas Um Caso Clínico de Pseudoaneurisma da Artéria Radial Após Punção Radial Repetida para Realização de Gasometria |
title |
A Case Report of Radial Artery Pseudoaneurysm After Repeated Radial Puncture for Arterial Blood Gas |
spellingShingle |
A Case Report of Radial Artery Pseudoaneurysm After Repeated Radial Puncture for Arterial Blood Gas Carvalho, Nuno Aneurysm, False/diagnostic imaging Blood Gas Analysis/adverse effects Emergency Service, Hospital Point-of-Care Systems Radial Artery/diagnostic imaging Ultrasonography Artéria Radial/diagnóstico por imagem Falso Aneurisma/diagnóstico por imagem Gasometria/efeitos adversos Serviço de Urgência Hospitalar Sistemas Automatizados de Assistência Junto ao Leito Ultrassonografia |
title_short |
A Case Report of Radial Artery Pseudoaneurysm After Repeated Radial Puncture for Arterial Blood Gas |
title_full |
A Case Report of Radial Artery Pseudoaneurysm After Repeated Radial Puncture for Arterial Blood Gas |
title_fullStr |
A Case Report of Radial Artery Pseudoaneurysm After Repeated Radial Puncture for Arterial Blood Gas |
title_full_unstemmed |
A Case Report of Radial Artery Pseudoaneurysm After Repeated Radial Puncture for Arterial Blood Gas |
title_sort |
A Case Report of Radial Artery Pseudoaneurysm After Repeated Radial Puncture for Arterial Blood Gas |
author |
Carvalho, Nuno |
author_facet |
Carvalho, Nuno Blaivas, Michale Caroselli, Costantino |
author_role |
author |
author2 |
Blaivas, Michale Caroselli, Costantino |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Carvalho, Nuno Blaivas, Michale Caroselli, Costantino |
dc.subject.por.fl_str_mv |
Aneurysm, False/diagnostic imaging Blood Gas Analysis/adverse effects Emergency Service, Hospital Point-of-Care Systems Radial Artery/diagnostic imaging Ultrasonography Artéria Radial/diagnóstico por imagem Falso Aneurisma/diagnóstico por imagem Gasometria/efeitos adversos Serviço de Urgência Hospitalar Sistemas Automatizados de Assistência Junto ao Leito Ultrassonografia |
topic |
Aneurysm, False/diagnostic imaging Blood Gas Analysis/adverse effects Emergency Service, Hospital Point-of-Care Systems Radial Artery/diagnostic imaging Ultrasonography Artéria Radial/diagnóstico por imagem Falso Aneurisma/diagnóstico por imagem Gasometria/efeitos adversos Serviço de Urgência Hospitalar Sistemas Automatizados de Assistência Junto ao Leito Ultrassonografia |
description |
Arterial blood gas, with subsequent radial arterial puncture as a simple access point, comprises a ubiquitous medical procedure in the diagnostic workup of patients admitted to the emergency department with dyspnea. Despite being a relatively safe and technically straightforward procedure, due to its considerable use, it is of vital importance to be able to promptly recognize its potential complications. We present the case of a 96-year-old female patient admitted to the emergency department with dyspnea and cough who underwent left radial arterial puncture for arterial blood gas. A total of three puncture attempts were performed until arterial blood was collected. Roughly two weeks upon observation, the patient was readmitted to the emergency department after the insidious appearance of a painful swelling in the left wrist, with progressive worsening since hospital discharge. On physical examination, a painful erythematous pulsatile swelling in the left wrist’s volar aspect was observed, and further point-of-care ultrasound evaluation documented a cysticlike collection, communicating with the radial artery’s lumen, and suggesting the probable diagnosis of iatrogenic radial pseudoaneurysm. The patient was hospitalized and underwent surgical resection of radial pseudoaneurysm, with subsequent arterial repair. Although severe complications from arterial blood gas have a low incidence rate, prompt diagnosis and management are required. Therefore, point-of-care ultrasound, as an additional diagnostic tool, may play a role in minimizing the risk of procedural complications. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-11-20 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19697 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19697 |
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por |
language |
por |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19697 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19697/15292 |
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Direitos de Autor (c) 2023 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2023 Acta Médica Portuguesa |
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openAccess |
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application/pdf |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 37 No. 1 (2024): January; 42-45 Acta Médica Portuguesa; Vol. 37 N.º 1 (2024): Janeiro; 42-45 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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