To the Editor:
I read with interest the report by Truong et al.1
in which they describe the occurrence of a radial artery pseudoaneurysm after radial artery catheterization for monitoring. The authors state that the catheterization was accomplished on the first attempt. Because there was no apparent trauma and the wound culture grew out Staphylococcus aureus
, this complication was apparently due to infection.
In their report, the authors do not describe the details of the placement, in particular the sterile prep and drape, and dressing used. That would have been important information to include. It is currently recommended that a sterile dressing with chlorhexidine be used. In our institution, we routinely use the Tegaderm CHG (3M Healthcare, St. Paul, MN). In addition to adhering tightly to the skin, it has a chlorhexidine-impregnated gel which contacts the insertion site. To the best of my knowledge, we have not had any infections related to arterial catheterizations with the use of such a dressing. Infection and subsequent radial artery pseudoaneurysm are rare and would suggest a possible departure from the standard sterile technique. Fortunately, the case described is a rare complication of radial artery catheterization.
Steven M. Neustein, M.D.
, Icahn School of Medicine at Mount Sinai, New York, New York. firstname.lastname@example.org
1. Truong AT, Thakar DR. Radial artery pseudoaneurysm: A rare complication with serious risk to life and limb. ANESTHESIOLOGY. 2013;118:188
© 2013 American Society of Anesthesiologists, Inc.