Pseudoaneurysm of the radial artery: A rare complication of coronary angiography by transradial route

ABSTRACT Radial artery pseudoaneurysm is an uncommon vascular complication of transradial coronary angiography. Prompt diagnosis and appropriate surgical management are essential to prevent rupture or ischemic complications. A 38-year-old hypertensive male underwent diagnostic coronary angiography via the right radial artery 2 months earlier. He presented with a gradually enlarging, painless, pulsatile swelling over the distal forearm, increasing from 1 to 3 cm in size. Examination revealed an expansile pulsatile mass with an audible bruit. Duplex ultrasonography confirmed a pseudoaneurysm arising from the distal right radial artery. Under regional anesthesia, surgical exploration revealed a small arterial rent with a false aneurysmal sac. The sac was excised, and the radial artery was ligated proximally and distally after confirming adequate ulnar collateral flow by Allen’s test. The postoperative recovery was uneventful, and hand perfusion remained intact. The patient was discharged on the 5 th postoperative day. Radial artery pseudoaneurysm, though rare after transradial procedures, should be suspected in patients with postprocedural pulsatile forearm swellings. Duplex ultrasound confirms the diagnosis. Surgical repair with excision and ligation offers a safe, definitive solution, preserving hand function and preventing complications.