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Figure 3 | SpringerPlus

Figure 3

From: Obstacles encountered during transradial angiography from after Radial Artery puncture to the aortic arch

Figure 3

Damage to the recurrent artery caused by the guide wire in a 72-year-old woman with a left vestibular Schwannoma. Resistance was felt to wire operation for sheath insertion, and fluoroscopy showed that it was caught in the recurrent artery in the elbow region. After repeated reinsertions, the wire was successfully inserted into the brachial artery, and the sheath could be inserted. Subsequent contrast showed extravasation (arrow) and a subcutaneous hematoma, but manual compression prevented the hematoma from expanding. Ultrasound scanning at a later date confirmed that there was no formation of pseudoaneurysm or arteriovenous fistula. The damage probably occurred when resistance was felt during insertion of the wire. This type of situation can be expected if the wire is forcibly inserted into the recurrent artery, and treatment must be applied to ensure that the hematoma does not become too large.

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