Radial Perforation

Radial artery perforation may result in hematoma and, in rare cases, compartment syndrome with increased risk of this complication in the setting of multiple antithrombotic agents. Radial artery perforation is usually managed by external compression and reversal of anticoagulation. In this clinical vignette, we report management of a radial artery perforation in the setting of rescue percutaneous coronary intervention with internal tamponade using a sheathless guiding catheter. This represents a simpler strategy than external compression and allows completion of the coronary procedure while treating the perforation. TAKE-HOME MESSAGES: Radial artery perforation can safely and effectively be managed with internal tamponade using a sheathless guiding catheter rather than external compression.