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Case Reports in Cardiology
Volume 2017, Article ID 8487056, 4 pages
https://doi.org/10.1155/2017/8487056
Case Report

Surgery Averted Using a Novel, Minimally Invasive Approach to Treat Very Severe Radial Artery Spasm

Department of Medicine, Cardiology Division, Brooke Army Medical Center, Ft. Sam Houston, TX, USA

Correspondence should be addressed to Anthony A. Cochet Jr.; lim.liam@lim.2tehcoc.a.ynohtna

Received 28 March 2017; Accepted 9 July 2017; Published 2 August 2017

Academic Editor: Man-Hong Jim

Copyright © 2017 Anthony A. Cochet Jr. and Daniel A. Bellin. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 42-year-old male admitted with a non-ST elevation myocardial infarction was referred for invasive angiographic assessment. Based on preprocedural assessment, the right radial artery approach was selected. Despite possessing none of the consensus risk factors for radial artery spasm, in addition to receiving standard arterial spasm prophylaxis and conscious sedation, the patient suffered very severe radial artery spasm with initial catheter placement, resulting in entrapment of a 5 Fr pigtail catheter within the left ventricle. After exhausting traditional methods for resolution of radial artery spasm, surgical intervention appeared to be the only remaining option for removal of the entrapped catheter. Prior to committing to surgery, use of an axillary nerve block to hinder sympathetic vascular tone was suggested and attempted. This intervention resulted in atraumatic catheter removal. We present a case of very severe radial artery spasm refractory to customary interventions, alleviated with a novel, minimally invasive technique, which spared surgical intervention.