Surgical treatment of digital ischemia occurred after radial artery catheterization

Permanent ischemic injury of the hand after radial artery cannulation is ra re, but several cases of thromboembolism after the cannulation leading to a mputation of affected limb or digits have been reported. A 48-yr-old man un dergoing spine surgery showed normal modified Alien's test and had no preop erative vascular disease. We inserted 20-G radial artery catheter for the c ontinuous monitoring of the blood flow and serial blood sampling. There was no specific event during the operation and the catheter was removed immedi ately after the operation. The signs and symptoms of the circulatory impair ment of the radial artery developed four days after the operation and aggra vated thereafter. Through the angiographic study, we found the total occlus ion of the radial artery and some of its branches. After an emergent surgic al exploration of the radial artery for removal of the thrombus and vein gr aft for the defect of the artery on the 8th postoperative day, the ischemic signs and symptoms disappeared and the radial pulse was restored.