Lee M K, Lee I O, Kong M H, Han S K, Lim S H
Department of Anesthesiology, Guro Hospital, Korea University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2001 Jun;16(3):375-7. doi: 10.3346/jkms.2001.16.3.375.
Permanent ischemic injury of the hand after radial artery cannulation is rare, but several cases of thromboembolism after the cannulation leading to amputation of affected limb or digits have been reported. A 48-yr-old man undergoing spine surgery showed normal modified Allen's test and had no preoperative vascular disease. We inserted 20-G radial artery catheter for the continuous monitoring of the blood flow and serial blood sampling. There was no specific event during the operation and the catheter was removed immediately after the operation. The signs and symptoms of the circulatory impairment of the radial artery developed four days after the operation and aggravated thereafter. Through the angiographic study, we found the total occlusion of the radial artery and some of its branches. After an emergent surgical exploration of the radial artery for removal of the thrombus and vein graft for the defect of the artery on the 8th postoperative day, the ischemic signs and symptoms disappeared and the radial pulse was restored.
桡动脉置管后手部永久性缺血性损伤罕见，但已有数例置管后血栓栓塞导致患肢或手指截肢的报道。一名48岁接受脊柱手术的男性改良艾伦试验结果正常，术前无血管疾病。我们插入了20G桡动脉导管用于连续监测血流和系列血样采集。术中无特殊情况，术后导管立即拔除。术后第4天出现桡动脉循环障碍的体征和症状，此后加重。通过血管造影研究，我们发现桡动脉及其一些分支完全闭塞。术后第8天对桡动脉进行紧急手术探查以清除血栓，并对动脉缺损进行静脉移植，缺血的体征和症状消失，桡动脉搏动恢复。
